Annual Progress Report FY 2018

The project focuses on adapting traditional quality improvement (QI) methods to community health, ensuring data collection, analysis, and use by community and sub-county work improvement teams to identify problems and come up with local solutions. The project builds on the strengths of an existing partnership between Liverpool School of Tropical Medicine, LVCT Health, and URC in quality improvement and community health. The project's overall goal is to contribute to the reduction of maternal and child mortality through increasing access to high-quality maternal and child health services at the community level and utilization of MNCH services at facility level. The objectives of the project include strengthening national and sub-county level coordination of the Community Health Strategy, reviewing existing tools for community health data collection, and setting SQALE indicators and agreeing a standard QI package. Key results of the project include strengthened national coordination for improved quality of community health programs, increased capacity of county decision-makers to prioritize and budget for community health programs using an equity approach, improved community health program performance in maternal and child health, and stronger community engagement. The project has achieved several key achievements, including the training of sub-county and community work improvement teams in QI methods, data verification ratios calculated for intervention community health units and sub-counties, and the institutionalization of QI follow-up interviews at sub-county and community unit level in Nairobi and Kitui. The project has also established work improvement teams at sub-county and community levels in Migori, conducted a household survey in Migori, and developed a county equity approach. The project has also made progress in improving data quality, with data verification ratios showing improvement in intervention community health units and sub-counties. The project has also seen an increase in confidence in routine data for monitoring performance and identifying problems. Additionally, the project has identified areas for action in child health, maternal health, newborn health, and nutrition, and has implemented a QI coaching strategy and a learning event. The project has also established a QI innovations fund, implemented a learning event, and institutionalized routine DHIS data for monitoring performance in intervention counties. However, the project has faced challenges, including a disconnect between national and sub-county level priorities in a devolved health system, and the inability to work at the national level due to USAID funding constraints.