EQUIP · Expanded Quality management Using Information Power for Maternal and Newborn Health in Africa

Maternal and new-born MDGs 4 and 5 will likely not be met in Africa despite the availability of evidence-based, affordable and appropriate technical interventions. Obstacles persist on both the demand side (low utilization) and supply side (low quality and lack of services), across the continuum of care from pregnancy to postnatal care. Priority must now be given to finding the mechanisms to bridge the “know-do gap”. Potential solutions include quality management and community involvement, where both approaches benefit from continuous, locally available, high-quality health information.We propose an innovative intervention in Tanzania and Uganda to improve maternal and new-born health with an expanded health system quality management approach that links communities and facilities using locally generated data. We will use Plan-Do-Study-Act cycles at community, health facility and district level powered by information from continuous multipurpose community and health facility surveys, with results presented in audience-specific report cards. In each country, we will use a plausibility design to evaluate health and quality outcomes in intervention and control districts, each covering 20–30 health facilities and their catchment populations in Tanzania and Uganda. Cost and community effectiveness of this intervention will be estimated with population and facility level indicators. Changes in contextual factors will be carefully documented to enhance our understanding of how health improvements were achieved. The impact on mortality will be modelled using the Lives Saved Tool. Policymakers will be involved throughout the project.Results will contribute to reaching the MDGs 4&5 in Africa. Furthermore, the intervention could serve as a more general model for scaling-up quality management of other health interventions in low-resource settings.