Quality is an essential consideration in providing and scaling up access to health services. This week I am in Nigeria, supporting training on a new tool to monitor and improve the quality of care provided in health clinics. The clinics are run by a national Non-Government Organisation and include a variety of static clinics, mobile services and outreach efforts to offer health services to communities.
The Quality of Care (QoC) tool has been developed through a series of Pan-African consultations with a diverse group of clinicians and programme managers. The result is a long list of questions, broken down into 4 different sections, formatted as something that resembles an Excel spreadsheet. The idea is that a QoC team will visit the different types of health service delivery points once every few months, to monitor and then track improvements, against that list. The questions cover areas ranging from environmental health, such as waste disposal, hygiene and infection control; to counselling techniques and confidentiality; to record keeping, security and commodity stores. At the end of the visit, the QoC team feed back their observations with host facility, who then make plans to respond in practical ways to the observations so that they have improved their overall score on the QoC tool the next time the team pays them a visit.
Yesterday I was with one of the QoC teams as they practised using the tool at a clinic in the North West of Nigeria. It struck me that the most useful thing about the tool is the conversations it triggered rather than the answers to the yes/no questions or the scores that it generated.
The conversations that we had, the the feeling of commitment that we witnessed will last much longer than the already faded memory of the tally of the score.
Walking back into the training room today, two simple notes that are posted up on a flipchart on the wall remind me that quality of care is neither an exact science or an art. It is one of common sense and human connectedness, based on the simple and fundamental principles of respect and compassion.