ArticleBMJ open quality2020
How to prioritise in quality improvement? Targeted implementation as a key for quality improvement in Kenyan health facilities.
Article in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Hospital Accreditation Governance in Afghanistan: Challenges and Solutions.Journal of healthcare leadership · 2026Article
- A qualitative study of perceived facilitators and barriers to adoption of continuous quality improvement in Western Kenya using the Consolidated Framework for Implementation Research (CFIR).BMC health services research · 2025Article
- Nationwide data-driven quality improvement in ultrasound medicine: insights from an indicator-based initiative in China.BMJ open quality · 2025Article
- Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review.BMJ open · 2023Article
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Authors and funding
10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundData from national surveys of low- and middle income countries indicates that there is still a need to improve the quality of healthcare in resource-poor settings. This study aims to understand the benefit of an integral, facility-driven, indicator-based approach used as a decision-making tool to define effective quality improvement interventions in Kenya.
objectiveThe aim of the study is to understand whether the integral approach developed leads to effective interventions.
methodsCategorical data is collected from ten health facilities covered by the Integrated Quality Management System (IQMS) project in Kenya. First the information on concrete improvement interventions implemented within the facilities is collected and merged into five different intervention topics. Second, groups of facilities with similar quality improvement interventions are selected to compare between the first and second quality assessment rounds. Those IQMS indicators matching the content of the intervention topic are extracted from the software VISOTOOL. In a third step, the data is summarised using means and SD. A one sample T-test is applied on the mean changes and SD. Frequency counts and percentages were used for the presentation of categorical data.
resultsAll improvement interventions resulted in positive and higher change values (T2-T1). Four of five intervention topics, show statistically significant improvements including neonatal mortality (42%; p<0.0001), waiting time (39%; p=0.0490), infection prevention control (28%; p=0.0007) and with shortages of staffing and transport in remote areas (32%; p=0.0194).
conclusionsIn all facilities the interventions selected have a positive impact, some of which markedly improved. It demonstrates that this integral quality improvement approach in Kenya can serve as an effective decision-making tool for identification and prioritisation of interventions. Those targeted interventions, being performed under institutionalisation in form of coaching and tutoring, effectively contribute to improving the quality of care in resource poor settings.
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