The HWHF project utilizes the two-part “Model for Improvement” framework. First, participants define their intended achievement, contribute ideas that might make a difference, and define measures to understand if improvement occurred. Second, implement “Plan, Do, Study,  Act” (PDSA) cycles  to see if updated approach leads to the intended results.  

Beginning in September 2022, service providers collected data on pregnant women receiving ANC services, including albumin and hemoglobin (Hb) testing. Data was managed using an online platform. Targets were agreed upon at the start of the project; data were collected by the service providers and the results were tracked at each facility.  Work Improvement Team (WIT) met weekly to review the PDSA cycle. 

Results

In September 2022 at baseline,  albumin and Hb testing were performed for 43% and 58%, respectively, of pregnant women during ANC service in the urban slums of Tongi. A target was set to increase performance of both albumin and Hb testing to 86%  of pregnant women during ANC service between October 2022 to March 2023. The target was not achieved by March 2023.

Key ideas for change were:

As seen in the figure below, improvements in albumin and Hb testing for ANC services were observed between April 2023 and March 2024. ANC coverage for albumin and Hb testing had already passed 90% from April 23 to March 24, showing continuous quality improvement for ANC services.

Conclusions

The “PDSA” Cycle…