Strengthening of Quality Management Structures in the Malawian Healthcare System with a Focus on Reproductive Health

Area of competence: 
Health Policy and Financing
Donor organization: 
GIZ (German Agency for International Cooperation)
Start of Project: 
End of Project: 
Value of service: 
€ 2,302,159
Description of Project: 

The project supports the Malawi German Health Programme in the strengthening of Quality Management within the Malawian healthcare system and aims at improving the quality and management of health services of public and private providers, especially in maternal/ neonatal health and family planning.

Technical Assistance concerns the institutionalisation of a central-level Quality Assurance Unit, housed in the Department of Planning and Policy Development (DoPP) within the MoH, as well as the strengthening of QM structures at decentralised and facility-level.

Service quality will be raised in line with the integrated national standards for Infection Prevention and Sexual and Reproductive Health and Family Planning (SRH/FP) through improvements in quality management at facility level, and by institutionalizing quality assurance systems at MoH and in the Malawi Council of Medicine (MCM) and the Nurses and Midwives Council of Malawi (NMCM).

Description of Services: 

The project operates at several levels to improve the quality of health service delivery.

At national level, advisory services are offered to assist the setting up and institutionalisation of a national-level QA Secretariat. At district level, our experts advise institutions in further developing their care and referral systems, in improving quality management procedures within the facilities and better integrate services. Health service managers at all levels are advised to increasingly use improved routine information for evidence-based decision-making, for the identification of quality deficiencies and the planning for improvements.

National level activities:

  • Support MoH in the establishment, staffing, and operationalisation of a QM Unit at MoH
  • Develop job descriptions and ToR for the QM Unit members
  • Establish reporting lines
  • Develop annual work plan of the QM Unit

District level activities:

  • Support to 14 BEmONC and 4 CEmONC sites in the four target districts to establish fully functional Quality Improvement Teams (QITs) through capacity building, coaching, self-assessments, collaborative sessions and the design and implementation of thematic action plans
  • Training of managers and service providers across the four districts have been trained in the basic concept, tools and techniques of Quality Assurance (QA)
  • Training of managers and services providers in coaching and adult learning principles
  • Introduction to the concept of QA

In addition, at district level, mentorship interventions are implemented targeting the same 14 BEmONC and 4 CEmONC to improve maternal and newborn health (MNH).

  • Develop a master plan with key topics to be covered through skills lab sessions, case review meetings and bedside teaching
  • Identify MNH motivators and assign them to one of the district to support institutionalizing the mentorship approach
  • Establish and operationalise skills labs within the maternities of the district hospitals
Project Volume: 
€ 2,302,159