Evaluation of the Quality Assurance Project and BASICS Joint Project in Niger.
OBJECTIVE
The 1998 evaluation sought to assess the Quality Assurance Project (QAP) in Niger since 1993 and the degree of quality assurance institutionalization in the Tahoua Department, and to summarize lessons from introducing the Integrated Management of Childhood Illness (IMCI) guidelines in a quality management (QM) environment.


METHODS
This evaluation collected data from interviews with staff and managers, from focus groups conducted in the communities, and from medical records. The data were then compared with three sources of evaluation criteria. A pre-project assessment provided a baseline across certain impact indicators for tracking progress. Other measures were derived from the objectives and indicators from the QAP/Tahoua project plan, the joint QAP/BASICS (Basic Support for Institutionalizing Child Survival Project) project plan, and from an additional US Agency for International Development (USAID) objective that the joint project be a model for West Africa.


METHODS
The evaluation took place in the two departments of Niger in which the joint project was carried out: Tahoua and Dosso. The QA Project launched a pilot program in Niger in 1993 to strengthen newly decentralized regional and district management, and to improve the quality of primary health care in Tahoua. The principal QA Project approach was QM. The BASICS Project became active in Niger in 1995, helping to improve child health services. In 1997, the projects merged in Niger to form the joint QAP/BASICS Project. The Ministry of Public Health (MPH) planned to implement IMCI in 1998, and wished to determine whether QM facilitated the introduction of IMCI.


RESULTS
The evaluation team found that QM had been effectively implemented in Tahoua and that there were related improvements in health program indicators. The team also found that the joint project had met most of its objectives and that QM facilitated the introduction of IMCI. A follow-up evaluation 2 years later found continued practice of QM by Nigerien health care providers.


CONCLUSIONS
Several factors contributed to the success of the Tahoua QA program and the joint project: teamwork, focus on patients, clarity of roles through standards, and synergy between the QA Project and the BASICS Project.
Legros
Stephane
S
Quality Assurance Project, University Research Co., LLC, Bethesda, MD, USA. slegros@jhpiego.net
Tawfik
Youssef
Y
Abdallah
Hany
H
Crespin
Xavier
X
Djingarey
Mamoudou
M
Catsambas
Tessie Tzavaras
TT
D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000592:standards; D005260:Female; D006077:Government Agencies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008297:Male; D008427:Maternal Health Services / Q000592:standards*; D009548:Niger / Q000453:epidemiology; D010865:Pilot Projects; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D014481:United States