Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships

BACKGROUND: Sierra Leone has among the poorest maternal and child health indicators in the world and investments in public health have been predominately to increase demand for services, with fewer initiatives targeting supply side factors that influence health workers’ work environment. This paper...

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Autores principales: Higgins-Steele, Ariel, Waller, Kathryn, Fotso, Jean Christophe, Vesel, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464036/
https://www.ncbi.nlm.nih.gov/pubmed/26062805
http://dx.doi.org/10.1186/1472-6963-15-S1-S4
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author Higgins-Steele, Ariel
Waller, Kathryn
Fotso, Jean Christophe
Vesel, Linda
author_facet Higgins-Steele, Ariel
Waller, Kathryn
Fotso, Jean Christophe
Vesel, Linda
author_sort Higgins-Steele, Ariel
collection PubMed
description BACKGROUND: Sierra Leone has among the poorest maternal and child health indicators in the world and investments in public health have been predominately to increase demand for services, with fewer initiatives targeting supply side factors that influence health workers’ work environment. This paper uses data from the Quality Circles project in a rural district of Sierra Leone to achieve three objectives. First, we examine the effect of the intervention on organizational skills and relationships among coworkers as well as between health workers and traditional birth attendants. Second, we examine whether changes in organizational skills are associated with changes in relationships among and between formal and informal health providers and between health providers and clients. Third, we aim to further understand these changes through the perspectives of health workers and traditional birth attendants. METHODS: The Quality Circles project was implemented in Kailahun District in the Eastern province of Sierra Leone from August 2011 to June 2013, with adjacent Tonkolili District serving as the control site. Using a mixed-methods approach, the evaluation included a quantitative survey, in-depth interviews and focus group discussions with health workers and traditional birth attendants. Mean values of the variables of interest were compared across sub-populations, and correlation analyses were performed between changes in organizational skills and changes in relationships. RESULTS: The results demonstrate that the Quality Circles intervention had positive effects on organizational skills and relationships. Furthermore, improvements in all organizational skill variables – problem-solving, strategizing and negotiation skills – were strongly associated with a change in the overall relationship variable. CONCLUSIONS: The Quality Circles approach has the potential to support health workers to improve their organizational skills and relationships, which in turn can contribute to improving the interpersonal dimensions of the quality of care in low-resource contexts. This method brings together peers in a structured process for constructive group work and individual skill development, which are important in low-resource contexts where active participation and resourcefulness of health workers can also contribute to better health service delivery.
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spelling pubmed-44640362015-06-25 Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships Higgins-Steele, Ariel Waller, Kathryn Fotso, Jean Christophe Vesel, Linda BMC Health Serv Res Research BACKGROUND: Sierra Leone has among the poorest maternal and child health indicators in the world and investments in public health have been predominately to increase demand for services, with fewer initiatives targeting supply side factors that influence health workers’ work environment. This paper uses data from the Quality Circles project in a rural district of Sierra Leone to achieve three objectives. First, we examine the effect of the intervention on organizational skills and relationships among coworkers as well as between health workers and traditional birth attendants. Second, we examine whether changes in organizational skills are associated with changes in relationships among and between formal and informal health providers and between health providers and clients. Third, we aim to further understand these changes through the perspectives of health workers and traditional birth attendants. METHODS: The Quality Circles project was implemented in Kailahun District in the Eastern province of Sierra Leone from August 2011 to June 2013, with adjacent Tonkolili District serving as the control site. Using a mixed-methods approach, the evaluation included a quantitative survey, in-depth interviews and focus group discussions with health workers and traditional birth attendants. Mean values of the variables of interest were compared across sub-populations, and correlation analyses were performed between changes in organizational skills and changes in relationships. RESULTS: The results demonstrate that the Quality Circles intervention had positive effects on organizational skills and relationships. Furthermore, improvements in all organizational skill variables – problem-solving, strategizing and negotiation skills – were strongly associated with a change in the overall relationship variable. CONCLUSIONS: The Quality Circles approach has the potential to support health workers to improve their organizational skills and relationships, which in turn can contribute to improving the interpersonal dimensions of the quality of care in low-resource contexts. This method brings together peers in a structured process for constructive group work and individual skill development, which are important in low-resource contexts where active participation and resourcefulness of health workers can also contribute to better health service delivery. BioMed Central 2015-06-08 /pmc/articles/PMC4464036/ /pubmed/26062805 http://dx.doi.org/10.1186/1472-6963-15-S1-S4 Text en Copyright © 2015 Higgins-Steele et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Higgins-Steele, Ariel
Waller, Kathryn
Fotso, Jean Christophe
Vesel, Linda
Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships
title Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships
title_full Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships
title_fullStr Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships
title_full_unstemmed Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships
title_short Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers’ organizational skills and relationships
title_sort peer-driven quality improvement among health workers and traditional birth attendants in sierra leone: linkages between providers’ organizational skills and relationships
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464036/
https://www.ncbi.nlm.nih.gov/pubmed/26062805
http://dx.doi.org/10.1186/1472-6963-15-S1-S4
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