Improving quality of care and measuring efficacy: Two weeks of training with healthcare providers in Togo

News article 27 Aug 2019

Togo, a small country in West Africa, has made significant progress in healthcare over recent years. Despite this, unfortunately out of every 100,00 live births in the country, 368 mothers still die. Additionally, 27 newborns die for each 1000 babies born in Togo. One way to address the heavy toll taken on maternal and newborn health is to ensure that women and babies receive high standard care during their pregnancy, childbirth and immediately after birth. There are many ways to improve the quality of care, including an improvement of infrastructure, supplies, knowledge or practices - each varying from place to place.

In July and August 2019, the Centre for Maternal and Newborn Health (CMNH) delivered two workshops at the National Midwifery School in Togo. Sixty healthcare providers, including midwives and doctors, from across the country were trained to implement “Standard-based audits” for antenatal (ANC) and  postnatal care (PNC) in their respective facilities. The training was delivered by a CMNH team, comprised of Dr Adama Traoré, Dr Florence Mgawadere, Dr Alexandre Quach and Dr Bakusa Dankom. This standards-based audit is a quality improvement method which includes identifying which areas of antenatal and postnatal care need to improve, holding facility-based meetings to initiate change to the delivery of care, and assessing the impact brought by this change. By empowering healthcare providers to build improvement strategies based on their own specific needs, quality improvement follows a dynamic and field-sensitive process.

The standard-based audits will be implemented as part of a 17 months “stepped-wedge” trial designed to assess the efficacy of the process on the actual quality of care. This will run from August 2019 to the end of 2020. The research will be piloted by the CMNH in partnership with the Ministry of Health in Togo and University of Lomé. The data collection will be carried out by healthcare providers using electronic tablets.

The involvement of the participants went beyond the team’s best hopes, with providers showing great enthusiasm to be involved in a way of offering better care to women and babies, and to be part of a pioneering research. The CMNH team came back with huge confidence in our coming teamwork over the course of the research.

Dr Alexandre Quach, Clinical Research Associate for the Monitoring and Evaluation department of the CMNH:
“Despite the very complex content of our training, these two weeks went by in a great manner thanks to the interest of the participants and happy atmosphere. It was good to feel that everyone in the room was aiming at the same goal”