Assessing the quality of care in a new nation: South Sudan's first national health facility assessment. Issue 10 (18th August 2014)

• Record Type: Journal Article
• Authors: Berendes, Sima; Lako, Richard L.; Whitson, Donald; Gould, Simon; Valadez, Joseph J.
• Is Part Of: Tropical medicine & international health. Volume 19:Issue 10(2014:Oct.)
• Page Start: 1237
• Page End: 1248
• Publication Date: 2014-08-18
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12363
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12363-abs-0001"> <title>Abstract</title> <sec id="tmi12363-sec-0001" sec-type="section"> <title>Objectives</title> <p>We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments.</p> </sec> <sec id="tmi12363-sec-0002" sec-type="section"> <title>Methods</title> <p>Using a two‐stage lot quality assurance sampling (LQAS) design, we conducted a national cross‐sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations.</p> </sec> <sec id="tmi12363-sec-0003" sec-type="section"> <title>Results</title> <p>Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick‐child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick‐child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in‐service training and supervision, for seven and ten states, respectively.</p> </sec> <sec id="tmi12363-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state‐by‐state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states.</p> </sec> </abstract>