I am thrilled to have a discussion about the need for better metrics and measurement for establishing best practices on correct use of maternal health supplies. As organizations focus on global maternal health, we need to evaluate provider practices and use of health supplies in the countries where we work. How are we going to address the gaps without first determining what the gaps are? Are providers short on supply? Do providers choose not to use certain products because of storage requirements? Are providers trained properly on the health supplies they’re being encouraged to use?
At Woman Care Global, we use an approach called medical detailing to support providers in the correct use and advocacy of women’s reproductive health supplies. Medical detailing is considered one of the few interventions capable of impacting provider performance. The core theory of medical detailing is to use support and training through frequent contact with providers to develop customized interventions to improve healthcare outcomes. Trained representatives visit medical practitioners regularly to determine the individual provider’s needs, motivations and barriers around the use of medical devices, products or services.
We have utilized, and had success with, medical detailing for a program we pioneered called Maximizing Provider Healthcare Performance™, or MAX for short. MAX representatives visit over 300 healthcare providers in Kenya and South Africa to gather information about the care being given to patients. The information is collected on tablets in the field and uploaded. Through a research partner, that data is analyzed to pinpoint which specific interventions lead to enhanced care. The representatives then follow up with each provider to implement the customized interventions indicated in each situation. They also share the provider’s own analyzed data with them each quarter, in order to provide a measurement of changes in service delivery, and to identify and discuss any gaps that may have resulted in decreased performance. The whole aim of the MAX program is to raise the bar on quality care delivery.
Now, I can happily talk strategy and create a bunch of flow charts about how the program works, but I want to emphasize one crucial element to the success of medical detailing. We have found the interaction between our MAX medical detailing representatives and the healthcare providers is the predominant determinant of success with both changing provider practices and collecting accurate data. Yes, the representatives are there to gather data, but they also take the time to talk, walk and drink tea with the clinicians we’re trying to reach. These interactions happen very naturally out in the field where trust and true partnership are developed over time. In an era of big data and analytics, we should never underestimate the impact of taking a minute to have a cup of tea and the value of engaging people. On a personal level, I am encouraged by programs that layer emotional intelligence and solid business practices. I am also truly and deeply encouraged by programs that take the first step and recognize that each subsequent step is meaningful.
“I long to accomplish a great and noble task; but it is my chief duty to accomplish small tasks as if they were great and noble.” – Helen Keller
Teaching providers how to properly use and advocate for health care products is a small task with big potential. Each woman helped will benefit and she will bring those incremental gains back to her family and her community. And that in itself is great and noble.
This post is part of the blog series “Increasing access to maternal and reproductive health supplies: Leveraging lessons learned in preventing maternal mortality,” hosted by the Maternal Health Task Force, Reproductive Health Supplies Coalition/Maternal Health Supplies Caucus, Family Care International and the USAID-Accelovate program at Jhpiego which discusses the importance and methods of reaching women with lifesaving reproductive and maternal health supplies in the context of the proposed new global target of fewer than 70 maternal deaths per 100,000 births by 2030. To contribute a post, contact Katie Millar.