Behavior Profile: Health care workers deliver quality services
Health Goal: Catalyze transformation of a holistic health system to sustain equitable improvements in health for all
Health care workers deliver quality services
Percentage of health facilities that have reached 85% based on the supportive supervision tool composite score

Behavior Analysis

Strategy

BEHAVIOR AND STEPS

What steps are needed to practice this behavior?

Health care workers deliver quality services as per National Guidelines

  1. Adhere to test and treat guidelines
  2. Adhere to counseling guidelines – use of job aids, techniques, etc.
  3. Respect clients throughout testing, treatment and counseling
  4. Engage community members
  5. Provide supportive supervision
  6. Use policy documents

FACTORS

What factors may prevent or support practice of this behavior?
Structural
Accessibility: Health care workers do not deliver quality services because they do not have sufficient operational funds at facility level to ensure availability of requisite resources needed for optimal service delivery.
Accessibility: Health care workers do not deliver quality services because they do not have available essential commodities needed to provide holistic services at health facilities.
Accessibility: Health care workers do not deliver quality services because they do not have essential equipment as required because of inadequate finances to procure.
Internal
Self-Efficacy: Health care workers do not deliver quality services because they have inadequate training and orientation at the preservice level ( both knowledge and skills) to meet requirement of service delivery.
Knowledge: Health care workers do not deliver quality services because they have limited knowledge on quality service delivery approaches due to ineffective and inefficient training methodologies.
Knowledge: Health care workers do not deliver quality services because they have limited access to critical printed materials (resources such as guidelines, job aides) to support reinforce knowledge and retention.
Skills: Health care workers do not deliver quality services because they do not receive coaching, mentoring , supervision and monitoring requisite for quality service delivery.

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior, and what actions must they take?
Institutional
Policymakers: Lead the co-creation of harmonized quality improvement approach with all stakeholders (Health facility regulatory authority, private sector, civil society) to ensure that relevant national policies are effectively implemented and monitored at all levels.
Managers: Explore effective and efficient ways to improve health care workers access to required guidelines, job aides, protocols.
Managers: Efficiently plan and match entrant health cadres knowledge to requisite skills during deployment.
Managers: Undertake leads periodic facility equipment mapping exercise to identify essential equipment gaps and make budgetary allocation to fill critical gaps at all levels.
Regional and Districts Officers: Adequately plan, implement and follow up on supportive supervision visits.
Regional and Districts Officers: Ensure adequately plan, budget and supervise effective management of resources at facility level.
Regional and Districts Officers: Provide financial management capacity building to facility heads.
Heads of Facilities: Adequately record, track and request needed commodities.

POSSIBLE PROGRAM STRATEGIES

What strategies will best focus our efforts based on this analysis?

Strategy requires Communication Support

Enabling Environment
Financing: Apply results based financing approaches as incentive for facilities providing quality services.
Institutional Capacity Building: Establish holistic training models such as leadership led quality improvement at all levels to ensure efficient and effective health care workers capacity building.
Institutional Capacity Building: Develop competency based pre-service training programs.
Institutional Capacity Building: Provide opportunities to facility management to build resource mobilization and financial management skills for facility operations.
Policies and Governance: Support MOH to utilize its convening platform to strengthen leadership and national governance of quality management structures and processes.
Policies and Governance: Support MOH to ensure that regulatory agencies are supported to undertake the necessary regulatory reforms and sanctions to improve service delivery.
Policies and Governance: Critically review HRH policies and adopt policies to effectively align pre-service education with national policies and guidelines.
Systems, Products and Services
Products and Technology: Adopt holistic equipment inventory needs assessment, procurement and maintenance.
Supply Chain: Support Quality Unit of MoH to strengthen linkages between quality of care and supply chain and ensure that MoH/GHS eadership implement effective supply chain policies to ensure availability of commodities to end users.
Quality Improvement: Adopt uniform national monitoring, evaluation, and learning of quality improvement approaches for continuous health systems strengthening.