title: [Integrated Quality Management System (IQMS): a model for improving the quality of reproductive health care in rural Kenya].
abstract: OBJECTIVE
  To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance.
  
  
  METHODS
  The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts.
  
  
  RESULTS
  260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed.
authors.affiliation: AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen. Electronic address: claudia.herrler@aqua-institut.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Herrler
authors.affiliation: AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen.
authors.forename: Anke
authors.initials: A
authors.lastname: Bramesfeld
authors.affiliation: AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen.
authors.forename: Marc
authors.initials: M
authors.lastname: Brodowski
authors.affiliation: evaplan GmbH am Universitätsklinikum Heidelberg.
authors.forename: Helen
authors.initials: H
authors.lastname: Prytherch
authors.affiliation: evaplan GmbH am Universitätsklinikum Heidelberg.
authors.forename: Irmgard
authors.initials: I
authors.lastname: Marx
authors.affiliation: Institute of Health Policy Management and Research (IHPMR) Nairobi, Kenya.
authors.forename: Maureen
authors.initials: M
authors.lastname: Nafula
authors.affiliation: GIZ Health Sector Program, Nairobi, Kenya.
authors.forename: Heide
authors.initials: H
authors.lastname: Richter-Aairijoki
authors.affiliation: Ministry of Health, Nairobi, Kenya.
authors.forename: Lucy
authors.initials: L
authors.lastname: Musyoka
authors.affiliation: evaplan GmbH am Universitätsklinikum Heidelberg.
authors.forename: Michael
authors.initials: M
authors.lastname: Marx
authors.affiliation: AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen.
authors.forename: Joachim
authors.initials: J
authors.lastname: Szecsenyi
mesh_terms: D001723:Birth Rate; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards*; D003906:Developing Countries; D005193:Family Planning Services / Q000458:organization & administration; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007630:Kenya; D008428:Maternal Mortality; D017146:Models, Organizational; D011247:Pregnancy; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000458:organization & administration; D034121:Reproductive Health Services / Q000458:organization & administration* / Q000592:standards*; D019035:Rural Health Services / Q000458:organization & administration* / Q000592:standards*; D017749:Total Quality Management / Q000458:organization & administration* / Q000592:standards*
keywords: Africa; Afrika; Entwicklungszusammenarbeit; Quality of care; Qualität der Gesundheitsversorgung; Qualitätsassessment; development cooperation; quality assessment; reproductive health care; reproduktive Gesundheit