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Sustaining Better Maternal and Newborn Care and Quality Improvement in Niger: Challenges and Successes
Collaborative improvement is a QI strategy to improve the quality of care and facilitate the emergence of a culture of quality in a network of participating sites, by bringing together the energy and creativity of different sites to address key quality issues in an efficient and effective manner. Little research has been done to document the extent of institutionalization achieved at the end of formal collaborative improvement activities.
This evaluation examines the extent of institutionalization of quality improvement after the end of technical assistance to an essential obstetric and newborn care (EONC) improvement collaborative in Niger that was launched in 2006. The study used a modified pre/post design to measure sustained gains and continued implementation of QI activities through the collaborative and post-collaborative period.
The experience of Niger offers some key lessons and some key insights into the institutionalization process. The 20 sites included in the study benefitted significantly from the EONC improvement collaborative activities, which provided both clinical and QI skills, coaching support, and opportunities to share results and effective changes. These benefits are reflected in the consistently high levels of compliance with EONC standards (verified through external chart review and direct observation of care) at the 20 sites.