Quality assurance management methods applied to a local-level primary health care system in rural Nigeria

P. S. Zeitz, C. G. Salami, Gilbert M Burnham, S. A J Goings, K. Tijani, R. H. Morrow

Research output: Contribution to journalArticle

Abstract

Introduction - Management of primary health care (PHC) systems in less developed countries is often impeded by factors such as poorly trained personnel, limited financial resources and poor worker morale. This study explored the ability of local-level PHC supervisors in rural Nigeria to use quality assurance (QA) management methods to improve the quality of the PHC system. Methods-PHC supervisors from Bama Local Government Area were trained for 3 days in the use of QA methods and tools. The supervisors targeted the supervisory system and the health information system (HIS) for improvement. Health worker performance in diarrhoea case management was assessed, using a simulated case, to measure the impact of supervision. A HIS audit assessed data collection forms used by 17 PHC facilities. Gaps in quality were monitored over a 2-month study period and flaws in work processes were modified. Results - PHC supervisors introduced a checklist during monthly visits to facilities to monitor how workers managed cases of diarrhoea. Performance in history-taking, physical examination, disease classification, treatment and counselling improved over the evaluation period. The HIS audit found that a variety of reporting forms were used at PHC facilities. After HIS reporting was standardized, the number of health facilities using a daily disease registry significantly improved during the study period. Conclusions - QA management methods were used by PHC supervisors in Nigeria to improve supervision and the HIS. QA management methods are appropriate for improving the quality of the PHC in Nigeria and in other less developed countries where at least a minimal PHC infrastructure exists.

Original languageEnglish (US)
Pages (from-to)235-244
Number of pages10
JournalInternational Journal of Health Planning and Management
Volume8
Issue number3
StatePublished - 1994

Fingerprint

primary health care
Nigeria
quality assurance
Health Status
Primary Health Care
health care
Delivery of Health Care
Health Information Systems
health information
management
information system
Health Facilities
Quality of Health Care
worker
audit
Developing Countries
supervision
Diarrhea
method
Disease

Keywords

  • Continuous quality improvement
  • Nigeria
  • Primary health care
  • Quality assurance
  • Total quality management

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)
  • Earth and Planetary Sciences(all)
  • Environmental Science(all)

Cite this

Quality assurance management methods applied to a local-level primary health care system in rural Nigeria. / Zeitz, P. S.; Salami, C. G.; Burnham, Gilbert M; Goings, S. A J; Tijani, K.; Morrow, R. H.

In: International Journal of Health Planning and Management, Vol. 8, No. 3, 1994, p. 235-244.

Research output: Contribution to journalArticle

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