Applying a standards-based approach to reduce maternal mortality and improve maternal and neonatal services in Mozambique

Abstract

This case demonstrates how a Quality Improvement (QI) initiative systematically improved the delivery of maternal and newborn health services at a large number of health-care facilities in Mozambique, with limited external assistance (e.g., external supervision or technical assistance after the initial 6 months), despite facing the challenges common to many low-income settings. In particular, this case examines the organization of a QI effort, including the formation of QI teams, enhancement of data collection to document QI activities, and national scale- up of a QI intervention. The QI intervention applied relied on provider training provider training on evidence-based standards, assessment of compliance with the performance standards, strengthening of the health management information system to enable tracking of selected quality-of-care indicators, and formation of facility- level QI teams to lead the implementation of the standards through performance assessments and action plans to address performance gaps, followed by recognition ceremonies if the facility achieved a high level of compliance with the standards based on an external assessment.