Lessons learnt from quality improvement collaboratives in Cambodia

Perry, Kelly E.; Rakhmanova, N.A.; Suos, Premprey; Nhim, Dalen; Voeurng, Bunreth; Bouchet, Bruno

doi:10.1136/bmjgh-2021-008245

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…The satisfaction test aids to collect critical feedback from healthcare service users on services they received. 17 In 2021, for example, 22.7% of users were dissatisfied with the services they received. According to previous experience, a lack of sufficient medicines in health facilities is the most critical feedback and key source of dissatisfaction frequently reported by users.…”

Section: Background -mentioning

confidence: 99%

Importance and Limitations of Healthcare Verification for Accelerating Implementation of Universal Health Coverage in Burundi

Nimubona

2023

EASci

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Introduction: As one of the avenues for implementing universal health coverage, healthcare verification for financing health facilities is receiving increased attention. Verification is the process of ensuring that healthcare services provided to users meet the predetermined criteria for billing and payment. The objective of this article was to examine the Burundi health system practices in healthcare verification for financing health facilities in order to identify strengths, limitations, and potential solutions for more advancement in universal health coverage implementation. Methods: A critical case study was used as the overall methodological approach and a narrative review design to draw conclusions about the case. Results: The results show that verification helps visualise the country’s level of progression in implementation of universal health coverage. While it promotes efficiency in healthcare service reimbursement by allowing payment for quality care services, verification has proven to be a resilient function to fraud, abuse, and waste in the demand for, and supply of, healthcare services. However, verification has some limitations in terms of services and population targeting, and technical effectiveness of the verification team. The most important way identified for alleviating these limitations is to separate the demand for, and supply of, healthcare services. Conclusions: More investments in research are required to recognise verification as an essential sub-function of health financing for universal health coverage implementation.

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Section: Background -mentioning

confidence: 99%

Importance and Limitations of Healthcare Verification for Accelerating Implementation of Universal Health Coverage in Burundi

Nimubona

2023

EASci

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“…The CPD program appears to have motivated healthcare professionals to learn (20), and the accreditation of CPD points seems to have been a key driver.…”

Section: Continuing Professional Development Programmentioning

confidence: 99%

Introduction and roll-out of self-learning App for midwifery during the COVID-19 pandemic and its sustainability in Cambodia

Nozaki,

Tsukada,

Sothy

et al. 2023

GHM

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Similar to other countries, coronavirus disease (COVID-19) pandemic significantly impacted not only the ability of midwives to deliver high quality maternal care, but also their ability to access professional development opportunities, including in-service training in Cambodia. In response, we developed a Cambodian version of Safe Delivery App (SDA), aligned to Cambodia's clinical guidelines. The SDA is a free digital job aid and learning platform for skilled birth attendants developed by Maternity Foundation that works offline and is used in more than 40 countries after adapting to the country context. In the year and a half since its launch in June 2021, SDA has become established in Cambodia, with more than 3,000 people, accounting for nearly half the number of midwives in Cambodia, downloading and using it on their devices, and 285 people having completed its self-learning modules. The review of the introduction process revealed that publicity on the professional association's social networking sites, in-person indepth hands-on training, and troubleshooting in a managed social networking group were useful in promoting the use of the application, and that the Continuing Professional Development Program accreditation has been a strong motivator for completing the self-study program. On the other hand, the COVID-19 pandemic has led to increased use of digital tools, but it is important to prevent the expansion of the digital divide when implementing new digital tools, including SDA.

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‘The objective was about not blaming one another’: a qualitative study to explore how collaboration is experienced within quality improvement collaboratives in Ethiopia

Hill

Keraga

Alemayehu³

et al. 2023

Health Res Policy Sys

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Background Quality improvement collaboratives are a common approach to improving quality of care. They rely on collaboration across and within health facilities to enable and accelerate quality improvement. Originating in high-income settings, little is known about how collaboration transfers to low-income settings, despite the widespread use of these collaboratives. Method We explored collaboration within quality improvement collaboratives in Ethiopia through 42 in-depth interviews with staff of two hospitals and four health centers and three with quality improvement mentors. Data were analysed thematically using a deductive and inductive approach. Results There was collaboration at learning sessions though experience sharing, co-learning and peer pressure. Respondents were used to a blaming environment, which they contrasted to the open and non-blaming environment at the learning sessions. Respondents formed new relationships that led to across facility practical support. Within facilities, those in the quality improvement team continued to collaborate through the plan-do-study-act cycles, although this required high engagement and support from mentors. Few staff were able to attend learning sessions and within facility transfer of quality improvement knowledge was rare. This affected broader participation and led to some resentment and resistance. Improved teamwork skills and behaviors occurred at individual rather than facility or systems level, with implications for sustainability. Challenges to collaboration included unequal participation, lack of knowledge transfer, high workloads, staff turnover and a culture of dependency. Conclusion We conclude that collaboration can occur and is valued within a traditionally hierarchical system, but may require explicit support at learning sessions and by mentors. More emphasis is needed on ensuring quality improvement knowledge transfer, buy-in and system level change. This could include a modified collaborative design to provide facility-level support for spread.

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Lessons learnt from quality improvement collaboratives in Cambodia

Cited by 4 publications

References 22 publications

Importance and Limitations of Healthcare Verification for Accelerating Implementation of Universal Health Coverage in Burundi

Importance and Limitations of Healthcare Verification for Accelerating Implementation of Universal Health Coverage in Burundi

Introduction and roll-out of self-learning App for midwifery during the COVID-19 pandemic and its sustainability in Cambodia

‘The objective was about not blaming one another’: a qualitative study to explore how collaboration is experienced within quality improvement collaboratives in Ethiopia

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