USAID Health Care Improvement Project (HCI) | Honduras

Overview

With field support funding from USAID/Honduras, URC assisted the Secretariat of Health (MOH) to put into effect its National Plan for Maternal and Child Mortality Reduction by providing technical support for continuous quality improvement. URC also provided technical support for implementation of performance-based management agreements and external quality control processes with hospitals, maternity clinics, and decentralized providers, in coordination with USAID’s health sector reform program. During 2010 and 2011, HCI provided technical assistance to the MOH to develop a National Quality Health System for the health sector that currently is in progress

Read more about the HCI project or visit the USAID ASSIST Project website.

Key Activities

  • Assisted central level health authorities to design a national quality system and a quality assurance policy to ensure the quality of health services and products
  • Supported regional quality coordinators to coach quality improvement teams at the facility level in carrying out regular monitoring of compliance with quality standards and improvement activities in services for essential obstetric and newborn care
  • Provided technical support to:
    • The MOH Quality Assurance Department to implement its National Quality Improvement Plan at the national level
    • The MOH to implement the Helping Babies Breath Initiative in 20 maternal clinics in five health regions
    • Escuela Hospital to strengthen the Kangaroo Mother Care Program
  • Also provided technical support to implement:
    • A national improvement collaborative to reduce hospital-acquired infections

      A regional improvement collaborative to reduce neonatal mortality from asphyxia, sepsis, and prematurity

    • An improvement collaborative for pneumonia and diarrhea in children under five years old

Achievements

  • The project helped update national maternal and newborn standards of care.
  • The number of continuous quality improvement teams increased from 7 in 2003 to 202 in 2009.
  • Prenatal care in compliance with standards at participating facilities increased from 0% at baseline to 88% in 2009.
  • Compliance with standards for treatment of pneumonia improved from 0% at baseline to 88% in 2009.
  • Treatment of diarrhea in compliance with standards improved from 0% in 2007 to 85% in 2009.
  • Follow-up treatment for children under five who had been treated for pneumonia increased to 91% at participating health facilities.
  • Active management of the third stage of labor is being practiced in 98% of deliveries at participating facilities and partograph use in 90%.
  • Compliance with standards in the management of obstetric complications include increases to 82% for treatment of hemorrhage, 80% for hypertension during pregnancy, and 86% for sepsis.
  • Compliance with standards for treatment of neonatal complications rose to 62% for asphyxia and 68% for premature births.
  • One municipality is requiring husbands to provide transport to the hospital at the time of childbirth and prohibiting violence against pregnant women. A violation results in fines that are set aside for transportation during childbirth.
  • The project helped design a national policy for implementing the National Quality Health System and its Basics Concepts Document in 2010.
  • It also helped develop norms for client satisfaction at hospitals in 2010.
  • It participated in training 20 maternal clinics in the Helping Babies Breathe Initiative.
  • In 20 maternal care centers supported by HCI in 5 health regions, the case of fatalities from newborn asphyxia fell from 22.7% between January to June of 2011, to 0% between March and May of 2012.
  • The total deaths from pneumonia and diarrhea among children under five in the Marcala District of the La Paz region feel from 17 cases in 2008 to 2 cases in 2011.
Duration
2007 to 2012
Funders 
US Agency for International Development (USAID)
Regions/ Countries 
Geographic Scope 
Nationwide with a special focus in 11 of the country’s 20 health regions: Atlántida, Colon, Comayagua, Copan, El Paraiso, Intibucá, La Paz, Lempira, Olancho, Santa Barbara, and Yoro