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Helping Babies Breathe —Kenya: Brief discussion of quality improvement processes

Helping Babies Breathe —Kenya: Brief discussion of quality improvement processes. Presented by Sherri Bucher , PhD, Indiana University School of Medicine Stella Abwao , MD, Save the Children/Saving Newborn Lives Helping Babies Breathe Global Developmental Alliance Meeting Washington, DC

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Helping Babies Breathe —Kenya: Brief discussion of quality improvement processes

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  1. Helping Babies Breathe—Kenya:Brief discussion of quality improvement processes Presented by Sherri Bucher, PhD, Indiana University School of Medicine Stella Abwao, MD, Save the Children/Saving Newborn Lives Helping Babies Breathe Global Developmental Alliance Meeting Washington, DC July 17, 2012

  2. Contributors Prof. Fabian Esamai, Moi University School of Medicine Pegeen Eslamai, MD University of Massachusetts Medical Center Peter Kaimenyi, MD, JHPIEGO, Kenya Nelly Ndugu, District Public Health Nurse John Wachira, MD National Resuscitation Council of Kenya

  3. Brief description of Helping Babies Breathe Activities in Kenya: June 2009-2012

  4. HBB-Kenya Activities 2009-2010 2009: Formative Evaluation of the HBB curriculum and materials by Moi University-Indiana University Schools of Medicine Partnership (funded by AAP with in-kind support from Laerdal) 2010: Expanded implementation field test (funded by USAID and AAP with in-kind support from Laerdal)

  5. HBB-Kenya Activities 2011 2011: Number of stakeholders and geographical reach of HBB expands; integration of HBB into ENC begins. Moi/IU Partnership and Kenya Pediatric Association perform trainings in Western Province Stakeholders from Government of Kenya, National Resuscitation Council of Kenya, MCHIP, USAID, and JHPEIGO integrate the HBB and ENC curricula. Kenya Pediatric Association, LDSC, and JHPEIGO perform trainings in Nyanza Province

  6. HBB-Kenya Activities 2012 • Evaluation of impact of HBB + ENC training on perinatal mortality rate (Global Network; funded by NICHD, Government of Norway, Laerdal) • NGOs such as UHAI/UMass partner with Kenya Pediatric Association. • MCHIP supports training of 21 National and Provincial Master Trainers to launch the HBB + ENC curriculum • Ministry of Public Health and Sanitation, Division of Child and Adolescent Health, leads stakeholder collaboration and coordination Geographical reach of HBB expands even further in 2012.

  7. Brief description of Quality Assessment and Quality Maintainenceprocesses utilized by HBB-Kenya stakeholders

  8. QA/QI BEFORE HBB Training • Careful selection of participants • Work directly with newborns • Attitudes, interest, and commitment to improving newborn care and reducing newborn mortality • “HBB Champions” • Obtain buy-in from administrators and supervisors • Educate on importance and benefits of HBB • Cooperation regarding staff rotation • Partner to support improvement and maintenance of HBB knowledge and skills

  9. QA/QI DURING HBB training: Emphasis on competence • 3 interrelated domains of competence • Knowledge • Skills • Performance • Pre/post evaluations (knowledge and skills) • Multiple choice questionnaire • Bag-and-mask ventilation checklist • Post evaluations (performance) • OSCE A • OSCE B

  10. QA/QI AFTER HBB + ENC training • Ensuring health worker competence • Trainees develop individual Action Plans • Trainees are encouraged to implement their Action Plans immediately upon return to work • Trainees receive follow-up support and on-the-job mentoring from Facilitators • Peer group problem-solving processes • Trained health workers observe, assess, and score one another using standardized indicators • Peer coaching is focused on performance improvement • External, cross-facility assessments performed by trained peers and supervisors from other health facilities

  11. Plans for scale-up and sustainability of HBB-Kenya QI efforts • HBB always integrated with ENC • Model the development and introduction of HBB + ENC QI metrics on existing standards for other MOH-sponsored MNH programs such as pMTCT and family planning • Integrate HBB + ENC into national pre-service training curricula • Encourage and support each facility’s review of neonatal mortality rates before vs. after training (data driven results)

  12. Selected Opportunities Need Augmenteddatabase and streamlined data collection processes by which to store training, monitoring, evaluation, and QI data Need funding to support bi-directional site visits, knowledge exchange activities, peer-learning, and mentoring facilities AAP and J &J Integrative Support

  13. Acknowledgements Dr. Peter Gisore, MD, Moi University School of Medicine Joseph de Graft-Johnson, MD, Save the Children Lily Kak, MD USAID Bill Keenan, MD, Saint Louis University School of Medicine Kenya Pediatric Association Dr. Khadija, Head, Division of Child and Adolescent Health Nancy Koskei, JHPEIGO, Kenya Laerdal Corporation Latter-Day-Saints Church Muthoni Magu-Kariuki, MCHIP—Kenya Dr. SantauMigiro(former head), Division of Child and Adolescent Health Ministry of Medical Services Ministry of Public Health and Sanitation National Resuscitation Council of Kenya Eileen Schoen, American Academy of Pediatrics Dr. AnnahWamae, Head, Department of Family Health Linda Wright, MD, NICHD

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