Tanzania
Quality Improvement and Recognition Initiative (Nuru Mpya)
Activity Dates
2002-2004
Activity Summary
HCP collaborated with the Ministry of Health Reproductive Child Health Section (MOH/RCHS) to implement the Quality Improvement and Recognition Initiative, branded Nuru Mpya or “new light” in Kiswahili, which focused on the improvement of reproductive and child health services. In the past, health services were free of charge. As decentralization and fee for service policies took hold in Tanzania, the Ministry realized that clients not only had the right to demand quality services, but were key actors in the development and sustainability of those services. The initiative was designed to roll out in three regions (17 districts). The key strategy was to recognize the achievements of facilities and their providers recognized once measured improvements were seen as a result of a quarterly facility assessment using a standard tool. When facilities began to meet the standards, a mass media campaign was designed to increase client demand for the improved services.
Major accomplishments of the initiative included capacity building of the MOH/RCHS, development of a standard facility assessment tool, collaboration with service CAs (INTRAH, JHPIEGO, and EngenderHealth) on QI activities, as well as gaining buy-in and support from senior level Ministry of Health officials, donors, and other relevant counterparts. The quality improvement efforts addressed: focused antenatal care, postabortion care (PAC), preventive treatment of malaria and syphilis screening and treatment in pregnancy, and family planning. The team of CAs worked with the MOH/RCHS to build the capacity at central, regional and district levels, including NGOs in these technical interventions. MOH/RCHS conducted a variety of quality improvement activities such as: formative research on communities, providers, facilities, Zonal Training Centres (ZTCs), and key stakeholders; analysis of quality improvement and recognition programs in other countries through a study tour; a community mobilization plan to introduce new participatory methodologies and interactive community theatre techniques; district-specific performance needs assessments; training of providers in focused antenatal care; hiring an advertising agency to work on logo/award development and the mass media component; facility assessment tool development, pretesting and orientation of assessment teams; and, consensus-building meetings for QIRI at national, regional and district levels to advocate for the initiative, garner support, and generate excitement among stakeholders.
Audience and Partners
The key implementing partner of the the QIRI initiative was the Ministry of Health Reproductive and Child Health Section and the Zonal Training Centres. Several CAs worked together to provide technical assistance to MOH/RCHS for QIRI. INTRAH focused on building capacity in QI/PI, and they, along with JHPIEGO and EngenderHealth, worked to improve competencies and proficiency of providers in reproductive and child services. HCP focused on the recognition component as well as generating demand for the improved services. The primary audience for the program was clients of RCHS services at Ministry of Health clinics, as well as service providers at those clinics.
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