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DRAFT MAQ Steering Committee Meeting Minutes
April 20, 2001

April 20, 2001
2:00 PM – 4:00 PM
Ronald Reagan Building
Washington, DC

Attendees: Elaine Murphy, Cynthia Steele, Maj-Britt Dohlie, Patricia Taylor, Lynn Bakamjian, Diana Silimperi, Young-Mi Kim, Carol Hart, Wayne Stinson, Thada Bornstein, Sharon Rudy, Linda Ippolito, Mona Byrkit, Robert Ainslie, Sarah Landon, Michelle Heerey, Jane Schueller, Anne Terio, Nomi Fuchs, Nicole Buono, Tita Oronoz, Rupal Sanghvi, Kris Lantis, Cathy Solter, Debbie Fagan, Paula Nersesian, Chris Davis, John Stanback, Judith Collins, Roberto Rivera, Ron Magarick, Jennifer Macias, Marcel Vekemans, Phyllis Piotrow, Jim Shelton, Kellie Stewart

1. Welcome

Jim Shelton welcomed the group.

2. Feed-back from the MAQ Mini-University

The first MAQ Mini-University took place on the morning of April 20 from 8:30 AM to 12:30 PM. Meeting participants discussed their impressions of the MAQ Mini-University. Overall, feedback was enthusiastic and participants found the event to be a fun and useful way to become updated on best practices in the RH field. Some suggestions were to make session times longer to allow for more discussion and to incorporate evaluation forms in order to get organized feedback from participants.

3. Update on upcoming MAQ Exchanges

CAIRO: Jim Shelton gave an update on the upcoming "Initiating Best Practices" (IBP) conference to be held in Cairo in the fall of 2001. The IBP is supported by a consortium involving representatives from USAID, WHO, and partnering agencies. The IBP is a four-day regional conference that will consist of the introduction of technical best practices through a Mini-University format, a leadership and organizational development capacity building component, and country application of best practices into on-going programs.

CENTRAL AMERICA: Kellie Stewart gave an update on the upcoming regional MAQ Exchange in Central America, which will be hosted in Honduras. This Exchange will follow a very similar format as the IBP, including a Mini-University, an organizational development component, and country applications. The Central America Exchange is being organized and implemented by MAQ and LAC Bureau at USAID, QA Project, and FHI. LAC Bureau is contributing $300,000, $150,000 which will be used as seed money for small follow-up projects following the Exchange.

NIGERIA: Jim Griffin gave an update on the upcoming Exchange in Nigeria which is currently scheduled to happen in the late summer to early fall of 2001. This Exchange is being headed by Pape Gaye of PRIME with support from Emmanuel Otolorin from the Quality of Care Center based at Makarere University in Uganda. The Nigeria Exchange will actually consist of three separate Exchanges to be held in three different states in Nigeria: Oyo, Bauchi, and Enugu.

Jim Shelton pointed out that we need to continue to update existing MAQ Exchange modules as technical best practices continue to evolve as well as create new modules. All those engaged in MAQ are encouraged to contact Kellie Stewart or Jim Shelton with current evidence reflecting evolving best practices in reproductive health and related fields in order to ensure that the most recent developments are incorporated into the MAQ Exchange curriculum.

4. Updates on Francophone Subcommittee meeting

Chris Davis, Mona Byrkit, and Judith Collins gave a summary of the recent MAQ Francophone Executive Bureau meeting that was held in Dakar, Senegal from February 19 – 22, 2001. In summary, the Francophone Executive Bureau has prioritized STI and HIV prevention efforts as their primary mandate. The Francophone Executive Bureau meeting in Dakar focused on strengthening the structure and function of the group as well as developing concrete and feasible activities that the group might undertake in the region in working towards their STI/HIV prevention objectives.

US-based Francophone Subcommittee representatives held a meeting on 4/19/01 to discuss the draft Action Plan from the February 2001 meeting, priority activities and next steps, narrowing the group’s focus to dual protection. Also, the group would like to pursue the idea of focusing on concrete activities in 2 or 3 countries and coordinating with SFPS on planning for the upcoming September 2001 conference on dual protection and syndromic management of STIs.

The next full meeting of the Francophone MAQ Subcommittee is proposed for September 2001 to be held in Dakar.

5. Subcommittee Updates

• Client-Provider Interaction: Elaine Murphy discussed the highlights within CPI in the past few months. In February 2001, there was a CPI panel at the SARC meeting held in Indonesia that included a presentation on counseling clients on side effects. On May 2, 2001, there was a CPI Subcommittee meeting held at PATH. Sharon Rudy, Pamela McQuide, Lois Schaefer, and Jill Tabbutt-Henry have recently finished a paper entitled "Training for Effective Client-Provider Interaction: Issues, Processes, and Recommendations" regarding effective processes and content for CPI training. Susan Palmore presented a summary of a CPI policy paper that she has been working on with colleagues that details how CPI policies are created as well as what the utilization and effects of policies have been. The research subgroup of the CPI subcommittee is looking for current research related to CPI. WHO is interested in working more closely on issues related to CPI and sent a representative, Sarah Johnson, to the CPI subcommittee meeting. The CPI subcommittee would like to look for ways to coordinate and collaborate with the CDQ subcommittee, one example being the "Smart Patient"work currently being done by Young Mi Kim.
• Technical Guidance: Roberto Rivera shared a newly developed Progestin-Only Pills (POP) Checklist which is meant to help providers determine whether a client is an appropriate candidate for POPs. Currently the use of POPs is generally limited to use with breastfeeding women who are amenorrheic. This checklist was developed due to interest in using POPs with non-breastfeeding women as well as with breastfeeding women who are menstruating.
• Policy, Advocacy, Communication, Education: Phyllis Piotrow gave an update on PACE’s recent activities. 500,000 copies of The Essentials of Contraceptive Technology have been distributed. There is a Portuguese version coming out in May and an Arabic copy will come out in the summer of 2001. Over 500,000 Tiahrt wallcharts have been distributed.

The MAQ website (http://www.maqweb.org) promises to be a great resource, but we all need to add to the content! CAs can help with making the MAQWEB a better resource by linking the MAQ related content on their own websites to the MAQWEB. To do this, please send titles of any materials and the URLs to Michelle Heerey at JHUCCP at mheerey@jhuccp.org. CAs could also help in the promotion of the MAQWEB by putting a link to it on their agency’s website. One good use of the MAQWEB recently has been to promote the MAQ Mini-University and make related materials available. Sharon Rudy suggested that a search engine be included on the website to make it more user friendly.

The group discussed some dissemination and promotional strategies to make MAQWEB more known including listservs, CA announcements, and MAQWEB bookmarks or stickers that could go out with distributions of Essentials of Contraceptive Technology. Another suggestion was to burn MAQWEB onto a CD-rom to make it available to partners in developing countries that don’t have access to the internet.

• Management and Supervision: Lynn Bakamjian reported that the M&S group held a subcommittee meeting at MSH in November 2000. There is a great deal of interest and innovative programming currently surrounding supervision concepts, which may in part be due to related interest in Performance Improvement and Organization of Work activities and meetings. For example, many programs are testing supervisor self-assessment, site supervision versus external supervision, and linking OJT to supervision with interesting results.

As a follow-up to this interest the M&S Committee has developed a workplan for the coming year which will solicit and review CA experiences with supervision and synthesize the results in a MAQ Series paper. Lynn reported that several CA's have already submitted information and she announced that the next meeting of the committee is June 7th.

• Gender: Bessie Lee reported that the MAQ/IGWG task force has plans underway to get a closer look into what is happening in the field regarding gender and MAQ. The group is moving towards implementing a formative research project through which host country partners working in the field will be interviewed about their perspectives on the importance of gender considerations as they relate to access and quality and how these are being incorporated into field programs. Kellie Stewart and Bessie Lee both pre-tested a draft interview guide in Zambia and Ethiopia respectively and changes have been made to the interview guide accordingly. The task force plans to hire a consultant to interview 3 "levels"of people working within organizations in the field: program director or senior technical staff member, clinic supervisor, health care provider who works directly with clients. In part, the upcoming MAQ Exchanges will offer a venue to conduct some of these interviews in order to take advantage of their broad scope of participants coming from the region.
• Community-Defined Quality:The CDQ subcommittee is newly formed and had its first meeting in November 2000. The group has developed a draft framework pulling together efforts that have happened over the past five to seven years and focusing on a rights and responsibilities approach.

The question was raised as to how the CDQ process can fit into the PI framework. One challenge is that many interventions are costly and resource intensive when looking toward integrating community involvement into the determination of desired performance and desired indicators.

6. Closing Remarks

The next MAQ Steering Committee Meeting will be held in early October 2001. The date will be announced.

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