MAQ Events and Awards
MAQ Open Partners
DRAFT MAQ Steering Committee Meeting Minutes
November 29, 2001
1:00 PM – 5:00 PM
Ronald Reagan Building
Washington, DCParticipants: Jill Tabbutt-Henry (EngenderHealth), Susan Palmore (Advance Africa), Douglas Huber (MSH), Jeff Spieler (USAID), Emma Ottolenghi (Pop Council), Lynn Bakamjian (EngenderHealth), Marcia Townshend (Catalyst), Jaime Stewart (CARE), Roberto Rivera (FHI), Wayne Stinson (MSH), Sylva Etian (USAID), Raja Rao (JSI), Diana Silimperi (QAP), Ron Magarick (JHPIEGO), Chris Davis (JHPIEGO), Wendy Voet (JHPIEGO), Susi Wyss (JHPIEGO), John Pile (EngenderHealth), Anne Morris (JHPIEGO), Jill Gay (Consultant), Elaine Murphy (PATH), Peggy Koniz-Booner (QAP), Dawn Crosby (URC-CHS), Kim Ethier (URC-CHS), Ebie duPont (QAP), Betsy Glazer (URC-CHS), Steven Goldstein (JHUCCP), Liz Creel (PRB), Heidi Reynolds (FHI), John Stanback (FHI), Judith Collins (FHI), Anna Helland (JHUCCP), Barbara Jones (CMS), Joseph Dwyer (MSH), Anne Terio (USAID), Marcel Vekemans (Intrah), Rebecca Kohler (Intrah), Robert Ainslie (JHUCCP), Michelle Heerey (JHUCCP), Jeannie Friedman (USAID), Phyllis Piotrow (JHUCCP), Nomi Fuchs (USAID), Margaret Neuse (USAID), Pat Taylor (JSI), Bob Rice (FHI), Michael Welsh (FHI), Colleen Conroy (NGO Networks), Suellen Miller (Pop Council), Rasha Dabash (Pop Council), Mihira Karra (USAID), Mark Rilling (USAID), Joanne Grossi (USAID)
Highlights:
- The "2nd Annual MAQie Award" was awarded to Pamela Lynam, JHPIEGO, Regional Technical Director, JHPIEGO/Kenya Office
- The "Lifetime MAQ Achievement Award" was presented to Phyllis Piotrow, JHUCCP
- The Management and Supervision subcommittee unveiled its "New Strategies for Supervision" MAQ Exchange module
Minutes
Welcome: Jim Shelton began the meeting by showing a few of the core MAQ slides that enforce the concepts of collaboration and partnership in meeting MAQ goals. He stressed that MAQ combines the challenge of both capturing and applying best practices.
- Best Practices Consortium: Jim Shelton discussed the formation of a group called the "Best Practices Consortium" which is made up of WHO, USAID, UNFPA, IPPF, and participating CAs. The purpose of the group is to document, disseminate, and support use of best practices in field programs. The Consortium worked together in delivering an "Implementing Best Practices" Conference in Nepal last year and has another one scheduled for Egypt in February of 2002. These regional conferences incorporate a strong focus not only on technical updates, but also in developing the leadership capacity needed for introducing and sustaining change at the field level. The question was raised regarding why these workshops are being held at a regional level versus a country-level. Susan Palmore responded that conducting the workshop at a regional level offers some cross-fertilization and the opportunity to share lessons learned between countries.
- Upcoming Exchanges: Kellie Stewart discussed the upcoming MAQ Exchanges which include Nigeria (March 18 - 21, 2002) and a sub-regional LAC Exchange (April 22 - 25, 2002). The Nigeria Exchange is a follow-on activity to an Performance Improvement Needs Assessment done December 2000 in the states of Enugu, Oyo, and Bauchi. The Exchange will also include these three states and incorporate many of the same stakeholders. The sub-regional LAC Exchange will take place in Honduras and include participants from Honduras, Nicaragua, El Salvador, Guatemala, and Dominican Republic.
- MAQ/Gender Study: Kellie Stewart discussed a collaborative study between MAQ and the IGWG that is currently underway in Kenya, Guatemala, and India. The objectives of the study are to 1) Examine current perspectives and practices in field programs regarding the integration of a gender perspective into RH programs, and how this fits with current approaches to improve access and quality and 2) Identify how the understanding of quality, access and gender may vary among levels of program staff within and across RH programs. The data will be collected through in-depth interviews with public sector RH staff, NGO staff, and women's NGO staff. In addition community focus groups and document reviews in each of the countries will be conducted. Study results are expected in May 2002.
- MAQ Supervision Module: Wayne Stinson and Lynn Bakamjian presented the new "New Strategies for Supervision" MAQ Exchange module that the Management and Supervision subcommittee has recently completed. The focus of the module is to share a vision of a supportive supervision strategy that reinforces quality outcomes at all levels. Supportive supervision is characterized by ongoing relationships/processes and by serving as an important link within the entire service delivery system. The supervisee is seen as the supervisor's "customer" and his/her satisfaction with the supervisory relationship is one indicator of good supervision. Roles for both external and internal supervision exist. Internal supervision is more practical and cost effective, however, external supervision affords the opportunity to share lessons learned across clinics. Self-supervision and team processes were stressed.
The M&S subcommittee is currently developing a paper that will reflect consensus on supervision processes and terminology and lend to the development of a framework. Evidence is being gathered regarding where supervision has worked and the lessons learned in scaling-up supervision.
Jim Shelton asked if a positive deviance approach is being used in relation to supervision.
JHPIEGO is working on this currently by conducting a high-performing health care site study to identify what special programs, people, or characteristics make one site more successful than another.
Phyllis Piotrow posed the question of whether different genders have different styles of supervision and suggested that this issue be explored further.
Subcommittee Report-Outs:
- Policy, Adovocacy, Communication and Education (PACE)
The PACE subcommittee held its biannual meeting the morning of 11/29. This was Phyllis Piotrow's last meeting as co-chair of the PACE subcommittee. Michelle Heerey from JHUCCP will be taking Phyllis' place as co-chair with Susan Palmore. Susan Palmore reviewed the topics that had been discussed at the PACE meeting during the morning of 11/29. Phyllis Piotrow presented Jim Shelton with a Tiarht Wallchart shirt that had been especially tailored for him in Bangladesh. Michelle Heerey showed samples of the promotional MAQ website bookmarks, stickers, and rolodex cards which are being included in the distribution of all PIP publications. Contact Michelle to request website promo materials for distribution within your agency and at quality of care related training, workshops, and other events you facilitate.
- Client-Provider Iinteraction
Elaine Murphy reported that the CPI subcommittee is completing the last two papers of the CPI "box set", which is comprised of a collection of four papers. The third paper will focus on supportive policy environments that support good CPI in service delivery. The fourth paper will focus on training for good CPI. Members of the subcommittee have been engaged in several conferences, including Global Health Council, APHA, and WHO's Essential Care Practice Guide meetings. Cynthia Steele is no longer co-chairing the CPI subcommittee, but Jan Kumar (EngenderHealth) and Young Mi Kim (JHUCCP) have taken co-chair positions alongside Elaine.
- Francophone
Chris Davis and John Stanback reported on a recent subcommittee activity that involved reviewing the Standards and Protocols in Benin, Mali, and Niger to look specifically at FP/STI/HIV content. The reviewers looked specifically for information re: dual protection, counseling, treatment, transmission, and adolescents. The results of the review will be communicated with Francophone subcommittee colleagues in the three countries as they move forward in considering integration activities and strategies. Judith Collins discussed the CISMA African Regional AIDS Conference taking place in December in Burkina Faso at which the attending subcommittee members based in the region will have an opportunity to meet.
- Community-Defined Quality
Robert Ainslie reported on the most recent CDQ subcommittee meeting in November. The group is currently working on revising the framework, developing indicators to determine CDQ impact, and looking for a new name. They are also beginning work on a MAQ Exchange module, a bibliography of different CDQ publications, and pulling together profiles of successful CDQ programs. They are interested in producing a SOTA paper for CDQ addressing its programmatic importance. The subcommittee has had the opportunity to work with WHO which is now seeing the community as a vital force. They are working with Bert Peterson at WHO on a framework and there is interest in getting IPPF and Euro NGO Networks involved.
Jim Shelton commented that devolution and decentralization may be in part driving CDQ because it provides tools to the municipalities in improving their health systems. Providers are pushed to be more client friendly to stay in business.
- Performance Improvement Consultative Group (PICG)
Bob Lande (PIP) is currently working on a Population Report dedicated to Performance Improvement. A PI course was offered in October and received very positive evaluations from participants. It will be repeated December 10 - 14. PICG now has a website (http://www.picg.net) and a listserv. If you are interested in being part of the listserv, please contact Jim Griffin (jagriffin@usaid.gov) or Rick Sullivan (rsullivan@jhpiego.org).
Douglas Huber suggested that the subcommittees focus more on reporting what is happening in programs and their impact. Jim Shelton commented that MAQ needs to have more collaboration, similar to the activities between Pop Council, FHI, and JHPIEGO involving introduction of the checklist to rule out pregnancy, dissemination training, and supportive supervision. Mihira Karra called for more attention to follow-up.
Application of Best Practices: Experiences in the Field
Lynn Bakamjian, EngenderHealth: "Taking Best Practices to the Field"
Lynn Bakamjian began by discussing the idea that there is lots of thinking underway regarding best practices, but the emphasis in RH literature is on clinical practice and pilot programming that shows that innovation adds value to practice. Taking a new practice or service to scale is often an overlooked design issues. Lynn presented EngenderHealth's work with taking Postabortion Care to scale, expanding on three phases: introduction, expansion, and institutionalization. She claimed that in order to successfully scale up, a program has to be a good fit with a CA, be generated from a long-term commitment, incorporate diversity, use a team approach, and use multiple dissemination channels to get information out.
Ron Magarick, JHPIEGO: "Applying TRH Best Practices in the Field"
Ron Magarick discussed JHPIEGO's approach in three interventions: strengthening pre-service education and training; competency-based training using anatomic models; and competency-based training in Postabortion Care using structured on-the-job training. In pre-service education and training, Ron discussed JHPIEGO's work in the Philippines which has resulted in the incorporation of FP/RH questions in national nursing/midwifery licensure examinations, implementation of curriculum components dedicated to FP/RH, and faculty who are competent to teach FP/RH knowledge and skills to students. In addition, the students who graduate are better prepared to provide FP/RH services, thus reducing the need for more costly in-service training. Use of anatomic models in training has been shown to increase training efficiency with higher level of competency in less time. Regarding JHPIEGO's PAC work, Ron discussed the use of a PAC/OJT self-directed learning package, its use in an ongoing project in Zambia and its importance for participants in settings where PAC caseload is low. In addition, Ron discussed the Regional Center for Quality of Health Care based at Makerere University, Uganda. This institution was established to provide leadership in building regional capacity to improve quality of health care by promoting best practices through networking, strategic partnerships, education, and training.
JHUCCP: "Strategic Communication: Best-Practices for Improving Health Behavior and Service Quality"
Michelle Heerey discussed a few of JHUCCP's projects that highlighted best practices in communication at three levels: client-provider interaction, community participation, and national scale programs. JHUCCP recognizes that the greatest sustainable impact is achieved when interventions target both the supply and demand sides. She discussed one intervention that works with providers to increase their facilitative communication skills with follow-up support strategies. Among providers that received no enforcement, self-assessment only, and peer support group activities, those that were involved in peer support groups showed the most sustainable change in facilitative communication skills. She also discussed the complementary "Smart Patient" coaching strategies in Indonesia, in which a trained educator goes through a set of exercises to prepare clients to proactively communicate with providers. Results showed that clients who were prepared prior to interactions with providers were more communicative during clinic visits and showed better contraception continuation rates. Michelle discussed a community participation intervention in Bolivia that focused on bringing together the community/client and provider perspective in defining quality. This community-based health information systems process was shown to have an impact on health behaviors within the community. She discussed the national Egypt Gold Star program and the parallel increase of accredited facilities with increase in CPR and decrease in TFR. Finally she discussed the Nepal radio communication project reaching both providers and community.
Advance Africa: "Using Best Practices to Improve Program Performance"
Susan Palmore discussed "Advance Africa", a relatively new project with the mandate to help Missions and in-country partners apply best practices, innovations, and lessons learned, including those related to HIV/AIDS and FP/RH integration. Advance Africa's primary purpose is to inform strategic decision-making by program managers as they work to improve program performance. To this end, it has put together a compendium of best practices, which have been organized into a "best practices pyramid". In the pyramid, best practices are broken into 5 levels: innovations, state of the art, better practices, best practices, and principles. Each level reflects an increasing amount of evidence that the practice is one that has been proven to give results. Best practices are broken down by five results: impact, demand, access, quality, and sustainability as well as by performance indicators, evidence of "success", and situational factors critical to success. Susan mentioned that Advance Africa will be working with Catalyst to form a "best practices" unit.
Lifetime MAQ Achievement Award:
Phyllis Piotrow of JHUCCP was presented with the "Lifetime MAQ Achievement Award". Margaret Neuse, Director of the Office of Population, presented Phyllis with a plaque thanking and congratulating her on her many contributions and achievements to access and quality and in the RH field.
The 2nd Annual MAQie Award was awarded to Pamela Lynam (JHPIEGO, Regional Technical Director, Kenya) for her numerous advancements to real field programs in improving access and quality, including contributions in the areas of COPE, supervision, training, and performance improvement. Congratulations, Pam!
|
|
|
|
|
Maximizing Access and Quality (MAQ) Initiative Site maintained by The INFO Project E-mail: webmaster@maqweb.org Security and Privacy Policy Disclaimer: The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government. |
 |
|