Facilitating National Health Systems Improvements and Policy Changes for Sustained Impact at National Scale

From left to right) Midwife Nadiatul Ferdous enters the patient information in the eMIS register; Mother Rumki providing KMC to her child Baitullah (28 days); A service provider using the chlorhexidine in the umbilical cord of a baby

With the view to strengthening national health system support, MaMoni MNCSP supports the 13 Operational Plans (OPs) taken up by the Government of Bangladesh Health, Population and Nutrition Sector Program (HPNSP 2017-2022) to achieve its goals of reducing the neonatal mortality rate below 18 (per 1,000 livebirths) and maternal mortality ratio below 121 (per 100,000 livebirths) by 2022. MaMoni provides embedded technical assistance to key OPs of the Ministry of Health and Family Welfare (MOH&FW) in the maternal and newborn health sector. This also includes supporting the network of institutions to strengthen approaches to clinical skills building. This is done through Quality Improvement (QI) initiatives such as capacity building trainings conducted by experts to service providers at different public health sector levels. The project facilitates improved coordination between service divisions and supports national efforts to strengthen public facilities to provide 24/7 maternal and newborn care (MNC). MaMoni MNCSP has also developed a costed national scale-up plan with allocated resources. The aim of the project is to ensure that quality is embedded within the system across the country at scale with a sustained impact.

MaMoni MNCSP project implements new and proven interventions and tools or approaches at scale, both in priority districts and nationally. It plans to develop tools for national level tracking or monitoring of MNC services’ strength of implementation. Through advocacy, dissemination, and consultation, MaMoni aims to ensure that lessons from implementation are regularly fed into national decision-making and planning. Establishing sustainable expansion mechanisms for engaging national decision-makers and stakeholders will also be done by the project, in dialogue with national implementing counterparts.

National Quality Policy and Strategy Update

In order to review the current state of health, healthcare systems, and Quality of Care (QoC) across Bangladesh, MaMoni MNCSP has various partners. With global partner Institute for Healthcare Improvement (IHI), the project has worked on updating the current National Quality Policy and Strategy (NQPS) in partnership with the Quality Improvement Secretariat (QIS) and Directorate General of Health Services (DGHS). MaMoni MNCSP has also co-developed an implementation plan to ensure that quality does not exist in silos and is embedded at all levels of the system.

Capacity Building

Capability building initiatives, which are tailored to suit the needs of individuals, are implemented at all levels of the healthcare system. Over the next five years, the team plans to contextualize and deliver a series of proven training methods across Bangladesh to build QI skills at all levels of the healthcare system. With this aim, the project works closely with the national training institutions to incorporate MNC and QoC in pre-service and in-service curricula for service providers, supervisors and managers, and to better integrate technical skills development with QoC and other health systems content. MaMoni MNCSP supports harmonized and standardized MNC training packages consistent with approved Standard Operating Procedures or SOPs, and involves training resource pools and QI Committees in implementation.