Quality Improvement in Global Health Partnerships

In 2008 NHS South Central launched a novel initiative entitled ‘Improving Global Health through Leadership Development’, aiming to provide both leadership development for NHS staff, and improve health in developing countries. The first partnership of the scheme was formed with the Maddox Jolie-Pitt Foundation in Cambodia, one of the poorest countries in the world with a human development index rank of 124 out of 169 countries. Since September 2008 over 30 health professionals (termed ‘fellows’) have had placements of between 2 and 8 months working with MJPs health team, focussing on capacity building, with an emphasis on applying quality improvement methodology to improve services at two rural health facilities supported by MJP. The NHS is attempting to embed the following 6 principles into its workstreams: The implementation of higher standards of clinical care with improved systems and processes Appropriate service delivery and improved access to care – getting the right skills, equipment and people in the right place and encouraging patients to use them The transference of technical, clinical and problem solving skills to MJP staff and other stakeholders. The development of a culture of continuing professional development (CPD) Supervision and support for Cambodian health workers Data collection for the assessment of outcomes, knowledge and skills from the current baseline position NHS Fellows have been applying RAID methodology (Review, Agree, Implement, Demonstrate) and PDSA cycles (Plan, Do, Study, Act) whilst working in Cambodia. They have been mentored by UK Quality Improvement experts. The findings from this evaluation suggest that ‘Improving Global Health through Leadership Development’ has contributed towards the improvement in health and healthcare within MJPs target area in Cambodia. There was evidence of changes in health services, and practices of Cambodian healthcare workers, attributable to the work of the scheme. The Cambodian experience of the process has been generally positive, but a number of challenges were identified. This study contributes to the existing body of knowledge on the effectiveness and impact of health links, in particular by seeking the views of the local population served by the link with regards to outcomes; i.e. changes in health services and practices. Future research areas could include evaluating cost-effectiveness, issues of sustainability and equity, specifically focussing on Quality Improvement and different methodological approaches to evaluation.