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Guide: Enhancing the performance of health care systems

March 12, 2018

Frontline health workers in low- and middle-income countries face significant challenges to providing high-quality services: inadequate staffing, wide gaps between evidence and practice, low demand for health services and too little use of data. To help workers address these problems, FHI 360 created the Quality Improvement Handbook, which offers step-by-step guidance on using evidence-based models to improve health system performance.

A community health worker shares ideas for improving health care services with his peers in northern Uganda’s Oyam District.The handbook, which is primarily intended for program managers and technical staff, provides tools and practical advice. The guide can help individuals or teams identify opportunities for change and design appropriate improvements, in addition to testing proposed interventions, assessing progress and applying lessons learned.

The handbook features five case studies and other examples that show how FHI 360 has used guidance and technical assistance to effectively mentor teams of health care workers in multiple countries, enabling them to:

  • Double the percentage of tuberculosis (TB) patients in Ukraine who received HIV counseling and testing services from TB staff — from 40 percent to 80 percent — through the RESPOND project
  • Increase the number of patients screened and treated for hypertension and diabetes at pilot primary care centers — from a few to hundreds — through the Abundant Health project in Vietnam
  • Raise the percentage of women and couples who visited their community health workers on time to continue the use of a family planning method — from 30 percent to 70 percent — through the Advancing Partners and Communities project in Uganda
  • Boost the enrollment of people with HIV in care and treatment services — from 59 percent to 78 percent — through the Clinical and Community HIV/AIDS Services Strengthening project in Mozambique

Since 2009, FHI 360 has implemented health system improvement projects in more than 20 countries. The handbook draws from this depth of experience, with the goal of empowering managers, clinicians, nurses and community health workers to independently improve their own practices and systems.

Photo caption: A community health worker shares ideas for improving health care services with his peers in northern Uganda’s Oyam District.

Photo credit: Christine Kim/University of North Carolina at Chapel Hill