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Quality Assurance of Family Planning Services in Rural Pakistan under the Suraj Social Franchise model Authors: Xaher Gul, Komal Daredia, Saeed Qureshi, Asma Balal, Shahida Naqvi Lightning Presentation Background Information MSS Service Delivery Network 126 Providers 12 Sindh 72 Punjab 42 KPK Field Worker Framework for Quality Assurance in SF Recruitment Feedback Monitoring of Client Experience Training Monitoring of Clinical & Non Clinical quality Source: The Basics of Quality Assurance in Social Franchising, Quality Assurance Framework Summary, UCSF Global Health Sciences, The Global Health Group 3 Background Information Selection Criteria for Suraj (Sun) Providers Good Reputation in community Private Qualified Providers Adequate Infrastructure Experienced in RH Service Delivery Located in non urban, low income area Accessible and willing for training Willing to abide by Suraj TOR’s Open to periodical audits and QA visits Willing to maintain Suraj Records Background Information Structure for QA visits • MSI QTA Annually Project Office Annually Region Office Quarterly • Client Exit Interview (Third Party) Methodology 367 Indicators Quality Assurance Scan Indicators Knowledge Assessment Infection Prevention (15 Indicators) (38 Indicators) Counseling Supplies (64 Indicators) (24 Indicators) Emergency Preparedness (67 Indicators) Clinical Administration (44 Indicators) Procedure Competency under Observation (115 Indicators) Source: MSS QA scan is adopted from MSI QTA Check list and modified from WHO FP Standards. Methodology 367 Indicators Accessed under 7 Categories Score Range 0-2 Score Achieved in each category ÷ Number of Indicators Accessed Total Score in all Categories ÷ Number of Categories Accessed Percentage Overall Score 85% & > 85 % Excellent 70% 84% Good Red Flag Issue 50% to 70% Average Non Compliance Issue < 50% Weak / Non Compliant Training Need Assessment Findings (Dec 12 – Jun 14) Perceived Quality 100% - clients 1/5 of all RHF clients cite satisfied provider reputation as the main reason for choosing SURAJ clinics for FP services. 99.9% clients expectation met or even exceeding 99.9% willing to recommend the health facility to others. Waiting Time 15 minutes 99.9% visit the facility again in the future. Findings (Dec 12 – Jun 14) Average internal QA scores of Suraj Clinics 99.25 Average QTA* Score [8 Providers randomly selected, December 2013] *Marie Stopes International conducts QTA assessment on an yearly basis Way forward Electronic QA Scans with Touch Tablets