Sub Progamme Review Meetings and
Annual Regional Review
Integrating Population Factors into
Development Planning
Improving
Quality of Care in Reproductive Health: A Pacific Perspective
Using Energising Games for
Participatory Advocacy
Niue: Halting Population Decline
| Vol. 7 No. 2 | Southpac NewsUNFPA Country Support Team for the South Pacific |
Dec 1999 |
IMPROVING QUALITY OF CARE IN REPRODUCTIVE HEALTH: A PACIFIC PERSPECTIVE Introduction Improving the quality of reproductive health care services clearly offers many benefits from the perspective of the client and the programme manager. The major components of quality of care are well established. However, in practice, quality of care is a complex matter; it is not easy to measure or to define because it involves a wide range of issues. Since the International Conference on Population and Development (ICPD) in Cairo in 1994 and other international conferences such as the 4th World Conference on Women in Beijing, 1995, and Safe Motherhood in Sri Lanka in 1997, countries throughout the world, including the small Pacific Island countries, have further affirmed their commitment to strengthen their efforts to improve the quality of their respective reproductive health programmes and services. As such, several countries have reported a positive shift towards the provision of quality and user friendly reproductive health services to meet the clients’ expectations as well as encouraging them to use such services. In the Pacific Island countries (PICs), the progress of this shift varies from country to country. It is more visible and very progressive in some, while it is rather slow and not as visible in others. Nevertheless, every island country is committed to the vision of ‘continuous quality’ improvement. Therefore, "to improve or not to improve the quality of reproductive health care services is not the question; the question is what, why, when, where and how?"
WHAT is Quality Reproductive Health Care? This writer defines quality reproductive health care as: "Accessing and availing of gender sensitive, safe and affordable integrated RH services of acceptable standards and environment, that satisfy the clients’ needs to be provided by appropriately trained and caring service providers and efficient managers." The writer based this definition on working experience and it aims to encompass most of the issues that contribute to quality of care. WHY Quality Reproductive Health Care? In terms of reproductive health it means helping couples and individuals meet their health needs safely and effectively. Additionally, it is the right thing to do. WHEN is Quality Of Care to be Implemented? In the PICs, the concept of quality of care is already being implemented but progress is still very slow. In regard to Reproductive Health Care, every effort is being made to improve quality. This is reflected in the Pacific Island governments’ placing high priority on promoting 'user friendly services' through training of appropriate staff, provision of equipment and supplies, upgrading of facilities, implementing of the RH community outreach awareness and activities along with regular review and assessment of existing programmes and services. This is an ongoing process. WHERE Do We Start and Where Do We Go From Here in Terms of Quality of RH Care? The need to improve quality does not have to start from a special place. The effort could commence from any of the areas that need strengthening, improving or even establishing or re-establishing. It is an on-going process. Limited resources are sometimes blamed for the uncertainty of where to start. Indeed, resources are important, but we do not have to wait, we can always start with whatever expertise is available and utilise the available materials. This leads our discussion to the consideration of the "HOW" aspect of quality of care. HOW Could the Quality of Health Care Be Improved? Most PICs are promoting the concept of 'integrated RH services' as one of the approaches to improving quality of RH care services. The PIC's overwhelming support of the concept of integration as an approach to improving RH quality of care is based on several favourable factors. Prominent among these factors are the following:
This integrated approach also promotes a closer working relationship among health care workers (functional integration), even though some of the services are located in different areas of the hospital or health care complex.
Conclusion Although ‘quality’ is an elusive and complex commodity, it is in great demand. Quality applies to everything in life. It offers many benefits even in the arena of health. However, in health, it will need the positive contributions of all the key stakeholders, especially the clients, the service providers and the managers supported by a well structured environment and services. In spite of its complexity, satisfactory results in quality of health can be achieved. With regard to improving the current standard of quality of care in RH, it is possible as every programme can improve, no matter what its budget scale or cultural setting, i.e. if everyone contributes. By Dr. Salesi F. Katoanga (Extracted from a paper presented at the WHO Regional Workshop on Women's Health, Beijing, China, 18-22 October, 1999) |
