EQUIP - Expanded Quality Management Using Information Power aiming to improve Maternal-Newborn health in Tanzania and Uganda
An EU-funded study between 2010 and 2014, implemented by Makerere University and Ifakara Health Institution, in collaboration with London School of Hygiene, Evaplan Ltd, and coordinated by Karolinska Institutet.
2010 - 2014
Maternal and new-born MDGs 4 and 5 will likely not be met in Africa despite the availability of evidence-based, affordable and appropriate technical interventions. Obstacles persist on both the demand side (low utilization) and supply side (low quality and lack of services), across the continuum of care from pregnancy to postnatal care. Priority must now be given to finding the mechanisms to bridge the know-do gap. Potential solutions include quality management and community involvement, where both approaches benefit from continuous, locally available, high-quality health information.
The EQUIP project proposed an innovative intervention in Tanzania and Uganda to improve maternal and newborn health with an expanded health system quality management approach that linked communities and facilities using locally generated data. Plan-Do-Study-Act cycles were used at the community, health facility and district level, powered by information from continuous, multipurpose community and health facility surveys, with results presented in audience-specific report cards. In each country, a plausibility design was used to evaluate health and quality outcomes in intervention and control districts, each covering 2,030 health facilities and their catchment populations in Tanzania and Uganda. Cost and community effectiveness of this intervention was estimated with population and facility level indicators. Changes in contextual factors were be carefully documented to enhance the understanding of how health improvements were achieved. The impact on mortality was modelled using the Lives Saved Tool. Policymakers were involved throughout the project.
The results will contribute to reaching the MDGs 4&5 in Africa. Furthermore, the intervention could serve as a more general model for scaling-up quality management of other health interventions in low-resource settings.