Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Training of Providers [12G

Abstract

INTRODUCTION: In Ethiopia, most medical graduates and midlevel health professionals lack the necessary competencies required to provide contraception and abortion care services. Since 2014, the Center for International Reproductive Health Training (CIRHT) has partnered with 11 teaching hospitals across the country to improve the quality of the pre-service education. The program aimed to improve the pre-service training through curriculum development, expanding hands on training and fostering a team science approach to research. This article summarizes the interventions used and outcomes identified in improving utilization and quality of care of abortion and contraception services to support the quality of training. METHODS: CIRHT created standards for model contraception and abortion care service clinics, known locally as “Michu” clinics. Quality improvement (QI) committees including faculty, residents, and nurses were established at all partner institutions. To identify major gaps in the quality of care of contraception and abortion services, each QI committee conducted a baseline audit. Using IHI’s Model for Improvement, each site defined their goals and measures to assess progress and intervention projects were tested using Plan-Do-Study-Act cycles. RESULTS: Currently, there are eight functional Michu clinics where residents, interns, and nurses are involved in service provision. In addition, all 11 teaching hospitals are now providing comprehensive contraception and abortion care services. The utilization for immediate post-partum family planning has doubled while safe first and second trimester medication abortion has become accessible to clients. CONCLUSION: CIRHT will focus its support on ensuring these model clinics and QI projects become part of the institutional structure of each teaching hospital.