Les équipes d’amélioration de la qualité contribuent-elles à la performance des agents de santé communautaire au Bénin ?

Lokossou, Virgil; Sombié, Issiaka; Somé, Donmozoun Télesphore; Dossou, Cyriaque; Awignan, Narcisse

doi:10.3917/spub.191.0165

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…An example of this came from a convergent mixed methods process evaluation of continuous quality improvement in South Africa [ 69 ] where health workers were discouraged by layers of managerial approval. In such cases across multiple PHC contexts, QI tasks were perceived to be time consuming—reducing health workers’ confidence in the QI initiative—and abandoned [ 45 , 48 , 49 , 52 , 54 , 58 , 59 , 62 , 67 , 69 , 71 – 75 , 81 , 83 – 85 , 90 ].…”

Section: Resultsmentioning

confidence: 99%

“…Lack of institutional knowledge, where implementers do not fully understand organizational bureaucracies, can also hamper QI [ 80 ] where planned changes are complex and system wide. QI teams with short tenure due to high staff turnover appeared to reduce organizational maturity for QI implementation, e.g., in Benin where QI team members took up new jobs, and lack of community support and irregular monetary incentives affected teams’ longevity [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Availability of resources to support QI was the focus of studies in Kenya [ 46 ], Uganda [ 52 , 57 ], Democratic Republic of the Congo [ 51 ], Zimbabwe [ 53 ], Ethiopia [ 54 , 72 , 82 ], Malawi [ 55 , 73 ], Haiti [ 56 ], India [ 59 ], Benin [ 58 , 89 ], South Africa [ 60 , 65 , 69 , 75 ], Tanzania [ 42 , 61 , 90 ], Zimbabwe [ 62 ], Rwanda [ 64 ], Namibia [ 66 ], Indonesia [ 70 ], Mozambique and Burkina Faso [ 79 ], Tajikistan [ 80 ], Mali [ 81 ], and Nigeria [ 44 , 45 , 86 ], underscoring its importance to impede QI and shared concerns across many LMIC contexts.…”

Section: Resultsmentioning

confidence: 99%

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Barriers to and enablers of quality improvement in primary health care in low- and middle-income countries: A systematic review

Odhus,

Kapanga,

Oele

2024

PLOS Glob Public Health

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The quality of health care remains generally poor across primary health care settings, especially in low- and middle-income countries where tertiary care tends to take up much of the limited resources despite primary health care being the first (and often the only) point of contact with the health system for nearly 80 per cent of people in these countries. Evidence is needed on barriers and enablers of quality improvement initiatives. This systematic review sought to answer the question: What are the enablers of and barriers to quality improvement in primary health care in low- and middle-income countries? It adopted an integrative review approach with narrative evidence synthesis, which combined qualitative and mixed methods research studies systematically. Using a customized geographic search filter for LMICs developed by the Cochrane Collaboration, Scopus, Academic Search Ultimate, MEDLINE, CINAHL, PSYCHINFO, EMBASE, ProQuest Dissertations and Overton.io (a new database for LMIC literature) were searched in January and February 2023, as were selected websites and journals. 7,077 reports were retrieved. After removing duplicates, reviewers independently screened titles, abstracts and full texts, performed quality appraisal and data extraction, followed by analysis and synthesis. 50 reports from 47 studies were included, covering 52 LMIC settings. Six themes related to barriers and enablers of quality improvement were identified and organized using the model for understanding success in quality (MUSIQ) and the consolidated framework for implementation research (CFIR). These were: microsystem of quality improvement, intervention attributes, implementing organization and team, health systems support and capacity, external environment and structural factors, and execution. Decision makers, practitioners, funders, implementers, and other stakeholders can use the evidence from this systematic review to minimize barriers and amplify enablers to better the chances that quality improvement initiatives will be successful in resource-limited settings. PROSPERO registration: CRD42023395166.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Barriers to and enablers of quality improvement in primary health care in low- and middle-income countries: A systematic review

Odhus,

Kapanga,

Oele

2024

PLOS Glob Public Health

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“…Lack of institutional knowledge, where implementers do not fully understand organizational bureaucracies, can also hamper QI [82] where planned changes are complex and system wide. QI teams with short tenure due to high staff turnover appeared to reduce organizational maturity for QI implementation, e.g., in Benin where QI team members took up new jobs, and lack of community support and irregular monetary incentives affected teams' longevity [57].…”

Section: Theme 3: Organization and Implementing Teammentioning

confidence: 99%

Barriers to and enablers of quality improvement in primary health care in low- and middle-income countries: a systematic review

Odhus¹,

Kapanga²,

Oele³

2023

Preprint

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The quality of health care remains generally poor across primary health care settings, especially in low- and middle-income countries where tertiary care tends to take up much of the limited resources despite primary health care being the first (and often the only) point of contact with the health system for nearly 80 per cent of people in these countries. Evidence is needed on barriers and enablers of quality improvement initiatives. This systematic review sought to answer the question: What are the enablers of and barriers to quality improvement in primary health care in low- and middle-income countries? It adopted an integrative review approach with narrative evidence synthesis, which combined qualitative and mixed methods research studies systematically. Using a customized geographic search filter for LMICs developed by the Cochrane Collaboration, Scopus, Academic Search Ultimate, MEDLINE, CINAHL, PSYCHINFO, EMBASE, ProQuest Dissertations and Overton.io (a new database for LMIC literature) were searched in January and February 2023, as were selected websites and journals. 7,077 reports were retrieved. After removing duplicates, four reviewers screened titles, abstracts, and full texts, and performed quality appraisal and data extraction and synthesis. 50 reports from 47 studies were included, covering 52 LMIC settings. Six themes related to barriers and enablers of quality improvement were identified and organized using the model for understanding success in quality (MUSIQ) and the consolidated framework for implementation research (CFIR). These were: microsystem of quality improvement, intervention attributes, implementing organization and team, health systems support and capacity, external environment and structural factors, and execution. Decision makers, practitioners, funders, implementers, and other stakeholders can use the evidence from this systematic review to minimize barriers and amplify enablers to better the chances that quality improvement initiatives will be successful in resource-limited settings.

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“…This in turn can lead to improvements in mothers' knowledge and infant feeding practices. Similarly, using a pre-and post-intervention design [10] concludes that in Benin, setting up QITs increased the performance of CHWs and the utilization of maternal and child health (MCH) services. In Ghana the SPRING project applied the Plan-Do-Study-Act (PSDA) cycle to quality improvement at both facility and community levels in order to strengthen the capacity of health workers and community health volunteers (CHVs) in the provision of infant and young child feeding and nutrition services [11].…”

Section: Introductionmentioning

confidence: 99%

Perceptions and experiences on community work improvement teams: the case of community health units in Kasarani sub-county, Nairobi, Kenya

Ambalu

Atwa

Otira

et al. 2022

Preprint

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Background: In Kenya, guidelines have been developed and activities undertaken aimed at improving the quality of health services in health facilities and communities. These efforts could help in contributing to the country’s goal of the highest standards of health for citizens. Current research on the subject is limited to whether the novel idea is understood and its benefits. This study takes a deep emic dive to understand the dynamics of work improvement teams (WITs) in the case of five community units within Kasarani sub-county of Nairobi City County, Kenya. Methods: Focus group discussions and key informant interviews were conducted with members of WIT. Interviews were recorded and transcribed, after which analysis conducted using NVIVO software was based on inductive coding. Results: Participants vividly recollect core WIT training and implementation aspects in particular the power of teamwork, the mentoring role of community health assistants (CHAs), and community innovations. Appreciation of WIT training and implementation finds expression in warmer reception accorded mothers referred by community health volunteers (CHVs); more open sharing of health concerns due to the social nearness of CHVs to community members; community own-resource contributions. Members of work improvement teams share a sense of empowerment post-training and feel triumphant after winning in WIT competitions. Experiences of WIT members include championing roles such as the CHV as the health educator, the CHA as the captain, and the chief personifying Government’s effective presence in the community. Similarly, the experience of disconnections between the community and the formal health systems is evident in respondent narratives, as are gapping (identifying health problems in the community), and discussion steps during work improvement. Enabling factors for quality improvement through community work improvement teams include passion, commitment, and self-motivation as well as team household visits. Nevertheless, hurdles within and external to mother, CHV, and facility levels persist. Conclusion: Respondents present fresh recalls, appreciations, and experiences on WIT training and implementation in Kasarani sub-county. These imply WIT efforts as inflection events propelling performance of community health units. The intervention should be scaled to other community health units and regions, considering enablers and challenges.

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Les équipes d’amélioration de la qualité contribuent-elles à la performance des agents de santé communautaire au Bénin ?

Cited by 4 publications

References 15 publications

Barriers to and enablers of quality improvement in primary health care in low- and middle-income countries: A systematic review

Barriers to and enablers of quality improvement in primary health care in low- and middle-income countries: A systematic review

Barriers to and enablers of quality improvement in primary health care in low- and middle-income countries: a systematic review

Perceptions and experiences on community work improvement teams: the case of community health units in Kasarani sub-county, Nairobi, Kenya

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