This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya.
This article describes how a mission hospital in East Africa expanded its quality improvement (QI) process by promoting partnership with the community in order to better meet the community's needs. The partnership evolved from the hospital's existing COPE (client-oriented, provider-efficient) self-assessment approach. In addition to seeking the views of clients, the hospital embarked on a process to engage community members in a dialogue, implement improvements suggested by the community, and gradually ensure community representation on its QI committee. The importance of considering the cultural diversity of the community was reinforced by the outcome of the COPE initiative.
As a result of its close collaboration with reproductive health organisations world wide, A VSC International1 developed a package of quality improvement approaches to encourage better use of human and physical resources. This paper focuses on A VSC's experiences in East Africa where the package of quality improvement approaches was first used. It describes each component of the package providing programme examples to illustrate how site staff and supervisors actually implemented the approaches.
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