Over the first three weeks of January, several Harvard School of Public Health graduate students took part in the Field Experience in Maternal Health winter session, organized by the Women and Health Initiative and the Maternal Health Task Force. In this blog post, Hannah Ratcliffe writes about her field experience with the Population Council in Bangladesh.
This January, I had the pleasure of interning in Bangladesh at the Population Council Dhaka office. I spent my three weeks there focusing on the improvement and automation of a quality assurance checklist for use in the Population Council’s Pay-for-Performance (P4P) project. The P4P project was designed to improve the quantity and quality of maternal and child health care services delivered in three districts of Bangladesh by offering financial incentives to reward service providers for meeting targeted levels of facility performance.
This project is one of the few being undertaken in Bangladesh that directly aims to improve quality of care. Quality is assessed quarterly by Quality Assurance Groups (QAGs) made up of technical experts from nearby medical colleges, hospitals, and professional bodies. In their quarterly assessments, QAGs use a Qualitative Measurement Tool to document and measure the quality of care being provided at a facility. The content of this tool was developed over the course of five consensus-building workshops organized by the Directorate General of Health Services in 2010 and attended by national and local-level program managers and service providers.
When I arrived in Dhaka, the Qualitative Measurement Tool was in an intermediate stage of development. I worked to edit the 500+ indicators included in the tool to make them clearer and to ensure that the point values corresponding to each indicator were accurate and self-explanatory. Working with the P4P team and a software developer, I also helped to design the layout and functionality of an electronic version of the tool. Our goal was to create an intuitive instrument that is structured to correspond with the progression of a QAG facility assessment and which allows for rapid, onsite calculation of results. The refinement of the Qualitative Measurement Tool is still underway, and I am looking forward to continuing to assist in its development from Boston!