Health Systems and Policy Research

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A "Model Quality Improvement System" for Maternal and Newborn Health Services Applicable for District and Sub-district Level Hospitals in Bangladesh: Description of Model Development Process

Islam F, Rahman A,Halim A, Eriksson C, Rahman F, Dalal K

Background: The quality of the hospitals of Bangladesh is not up-to the mark and as a result the maternal and newborn mortality rate is still high in comparison to the high income countries. Therefore, it is crucial to develop a quality improvement (QI) model considering the country context which will contribute greatly in reducing maternal and neonatal mortality in Bangladesh. Method and material: Documents review series of workshops with different tiers of researchers, professionals and programme personnel and a national level consensus meeting were conducted to develop an adapted "Model QI System" and its implementation process applicable for district and sub-district level hospitals of Bangladesh. The study was conducted during May - October 2012. Results: An adapted "Model QI System" and its implementation framework, guidelines and tools for maternal and newborn health services of district and sub-district level hospitals of Bangladesh were developed by considering the concept of WHO six building blocks of a health system and PDCA cycle along with 5S-KAIZEN-TQM approach. Taking into account the Bangladesh context the model included health system support, clinical service delivery, inter-departmental coordination; and utilization of services and client satisfaction as the key areas for quality improvement. Conclusions: Utilizing the existing information on quality improvement of hospital services an adapted "Model QI System" was developed for a resource constraint setting like Bangladesh. It is expected that the model could be effective in Bangladesh as similar kind of models were found effective in improving quality of hospital services in several countries in Asia and Africa.