Observations have been made and vindicated that in health facilities, lack of knowledge in ways to sustain and spread quality improvement (QI) projects within the districts is a worrisome problem. Although progress has been made in support of QI, spreading and sustaining improvement still remains a topic that needs a lot of attention and advocacy. Most QI projects never spread beyond their particular unit.
In NGOs perspective, sustainability means continuing to perform and deliver project benefits to the primary target group after termination of funding by the donor while spread means actively disseminating best practice and knowledge across a whole system and involves implementation of proven interventions in every applicable care setting. However, unless people buy into the project and are passionate about its goals, it will not last Until they own it, they cannot sustain it.
It was in view of this reality that Maikhanda Quality Improvement Team recently decided to hold a two day Collaborative Learning Session (CLS) at Sunbird Capital in Lilongwe. The CLS aimed at making the hospital management team and QI mentors understand their roles and responsibilities in sustaining QI gains and spread of high impact ideas going forward.
On the other hand, the collaborative also served as a platform for participants to share the activities on the Plan, Do, Study Act (PDSA) cycle they have been working on in the last action period to improve maternal and newborn health care in their local settings as well as get updates on the project progress and design in extension phase.
Speaking during the sessions, MaiKhanda QI Manager, Dr Mercy Makwakwa said it is very important that participating hospitals plan to sustain and spread improvements. The more people know about QI the sustainable it becomes. She was however quick to remind them that they must know what is working so that they can tell others clearly that something worked thereby equipping others with knowledge through their work.
“As a leader you must think holistically, the more people know QI the sustainable it becomes. Integrating sustainability principles in your ongoing projects is an effective way to ensure long term impact even when the Maikhanda project phases out. You must own these projects as you are not doing them for Maikhanda,” she said.
Through the two day session, participants were able to learn, develop and introduce new sustainability and spread change ideas to their projects which will help them continue and maintain quality improvement efforts even when the Maikhanda project phases out.
Participants were drawn from Dowa, Nkhamenya, Ntcheu, Mchinji, Mtengowanthenga, Dedza, Ntchisi, Mua, Salima, Nkhoma and Kasungu health facilities. They all presented different change ideas being implemented in their facilities to improve maternal and newborn care in Malawi for example early initiation, adherence and feedback on admission of low birth weight babies to Kangaroo Mother Care within an hour of birth; increase kangaroo mother care admission rate and monitoring of kangaroo mother care babies among other things.