Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana'a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana'a Governorate hospitals during "2017-2020", were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee's responses for sixth study dimensions were the top manager's commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

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Background The Expanded Program of Immunization (EPI) aims to increase immunization coverage. However, this cannot be achieved without an efficient data management system and without ensuring data quality. Objective We aimed to assess the quality of immunization data at Sana’a capital. Methods The World Health Organization data quality self-assessment tools were used. Three random urban districts and the only rural district (Bani-Al Hairth) at Sana’a capital were selected. From each district, one-third of the public health facilities (HFs) that were providing EPI services were randomly selected. Accuracy ratios (ARs), discrepancy levels (DLs), completeness, and timeliness were calculated from tally sheets and reports for Bacillus Calmette-Guerin (BCG) vaccines, third doses of pentavalent-3 (Penta-3) vaccines, and first doses of measles and rubella (MR-1) vaccines. The quality index was assessed for the five components (ie, recording and reporting, archiving, demographic information, core output/analysis, and using data for action) through a prestructured questionnaire. Results While the overall ARs and DLs for BCG, Penta-3, and MR-1 indicated overreporting at the HF level, there was overreporting for BCG and Penta-3 and underreporting for MR-1 at the district level. With regard to the overall quality index, recording and reporting achieved the highest score (90% and 96%, respectively), while using data for action had the lowest score (61% and 78%, respectively) at the HF and district levels. While completeness and timeliness were scored 100% at all HFs, both were inadequate at the Al-Sabain (93% and 99%, respectively) and Bani-Al Hairth (75% and 83%, respectively) districts. Conclusions The findings showed that the quality of immunization data in Sana’a capital’s HFs and districts was inadequate, with weaknesses in using data for action. Furthermore, completeness and timeliness were found to be unsatisfactory at the rural district and one of the urban districts. Ensuring data quality through strengthening the EPI data management system should be prioritized. Larger-scale and regular assessments of the EPI data management system are recommended.