Abstract: Purpose – The purpose of this study is to examine the impact and sustainability of the National Catholic Health Service (NCHS) Quality Improvement (QI) program on the reduction of under-5 mortality rates (U5MR) in Ghana. U5MR is the survival rate of children under the age of five, and it is an important indicator in the determination of a nation’s health status. It is also the Sustainable Development Goal 3 (SDG 3) to be achieved by 2030. QI in healthcare is a systematic and continuous approach to eliminate errors in the processes of providing health service, in other to improve health outcomes such as U5MR. QI process involves learning from experiences. It is a journey that never ends.
Design/Methodology/approach – The study takes the form of a descriptive case-study design, employing a quantitative approach. The study sample consists of nine Catholic hospitals used by the NCHS to test a QI methodology on U5MR reduction. The nine hospitals were their worst-performing hospitals in U5MR. Secondary data on U5MR spanning a period from 2008 to 2015 were collected from the hospitals and analysed descriptively using Microsoft Excel.
Findings – Overall, the implementation of the quality improvement program between 2008 and 2010 was determined to be a great success. Seven out of the nine pilot hospitals made remarkable reductions in U5MR between 92% and 65%. Sustaining these improvements was a challenge for the majority of the hospitals. Six out of the nine hospitals saw sharp increases in U5MR during the post-implementation stage (2011-2015). For example, a hospital with U5MR of 1.89 per 1000 live births in 2010 shot up to 21.19 per 1000 live births in 2011. Only three out of the nine hospitals sustained improvements beyond 2010. Lack of continuous supervision and a sustainability phase of the QI model contributed to the poor performance beyond 2010.
Practical Implication – For healthcare practitioners, this study points to factors to consider when implementing QI models in healthcare – for example, the need to include a sustainability phase in the implementation. This will ensure that improvements made during the implementation are sustained and further enhanced. This way, the SDG 3: zero preventable under-5 mortality by 2030 could be achieved.
Originality/Value – QI methodologies are new to the healthcare system in Ghana. Also, studies on the application of QI on healthcare delivery in Ghana is very limited. This study contributes to the understanding of the impact of QI efforts in healthcare delivery in Ghana. The study reveals the importance of a QI method in healthcare and how it should be implemented. In this study, the performance of the nine hospitals during the implementation and post-implementation stages were analysed. Thus, not only was the impact of the program measured but also its sustainability.
Keywords: Quality Improvement, management commitment, under-5 mortality rate, sustainability, Project Fives Alive!.
Title: The Impact of Quality Improvement on Healthcare Delivery in Ghana: A Secondary Data Analysis of Under-5 Mortality Rate Reduction
Author: Kumah Isaac Rock, Boison David King, Asiedu Esther
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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