Facility-Based Quality Improvement
Working in collaboration with the Ministry of Health, Zimba District Health Office, Healthcare Facility staff, Community Based Volunteers and community members we have co-designed a model rural health system, which we are piloting in Kanyanga and Chalimongela Rural Health Posts and looking to build evidence of impact of a holistic health system strengthening programme that could be adopted by Ministry of Health.
Following an extensive and collaborative design process we have identified the biggest challenges at both facilities and co-produced clear quality improvement roadmaps. Interventions will be designed and delivered by Zimba District Health Office, facility staff and community members with On Call Africa’s support.
Overview
Kanyanga is situated in a remote rural part of Zimba District in Southern Province. The facility is 80km from the nearest doctor, at Zimba Hospital, which is challenging to reach on poor roads. The health post has recently been developed to serve a very large catchment area, a population of 24,701. In this area there are outreach posts up to 40km from the health facility with no means of motorised transport.
Despite serving such a large population, the facility only has 4 health workers, serving 16 outreach posts. As a result services at the facility are often run and managed by Community Based Volunteers with limited and varying levels of training.
Following a 4 month assessment period this detailed report was produced. A summary of findings can be found below.
Following this assessment phase, On Call Africa, Ministry of Health, Kanyanga Rural Health Post staff and community members developed the following roadmap for improving the functionality of the health system:
Our role
On Call Africa works with the Rural Health Post to identify its biggest challenges and assess needs both at the facility, and within the communities in it’s catchment area.
As of June 2023, the following activities have been completed at the health facility:
- Capacity building of staff to address antibiotic stewardship, leading to a 22% improvement in prescribing accuracy
- Mothers’ shelter constructed, which has led to a 32% increase in the number of births at the facility
- Successfully dug a borehole and found a reliable water source for a health facility with no access to clean water previously
- Installation of a solar power system
- Delivered training to health workers and Community Based Volunteers
- Community Lead Total Sanitation (CLTS) training delivered to 51 community champions and teachers resulting in 215 pit latrines being brought up to Ministry of Health standards.
In 2023 we have secured funding to run water from the borehole to the health facility and provide running water at all points of care. We have also secured funding to construct toilets and showers that will bring the health facility up to the national standards for Zambia.