Quality is measured in multiple ways around the globe, but common, standardized metrics are still missing.
For this reason, Metrics for Management has set out to build tools that measure quality in the Family Planning, Abortion Service & Maternal Health areas.
METRIC: FAMILY PLANNING QUALITY
In light of the FP2020 global initiative and the inclusion of family planning in both the millennium and sustainable development goals,family planning services in low- and middle-income countries are receiving increasing attention. While health programs seek to provide quality services to users, maintaining that quality often requires a significant investment of time, personnel, and resources. This conflict both highlights the current lack of a common measure of family planning quality and creates a prime opportunity to establish one.Measuring quality will help programs know to what extent their investments are yielding results, and how it can inform prioritization of future efforts.Therefore, Metrics for Management,is working to develop a common measure of clinical family planning quality.
Promote standard indicator(s) of structural and process quality that are associated with reduced contraceptive discontinuation.
We envision a metric that will be:
- A consistent method to collect and report clinical family planning quality
- Correlated with discontinuation
- Used to identify areas for quality improvement
- Easy to collect and interpret
- Low cost to implement
In the fall of 2015, Metrics for Management convened 19 experts across a variety of disciplines – family planning service providers, global policy leaders, academics, researchers, and donor agencies – to define what the necessary steps are to develop a standardized measure of family planning quality.
Metrics for Management, with collaboration from Marie Stopes International and Population Services International, is leading research to identify quality measures most highly correlated with important family planning outcomes such as discontinuation. The next phase of the research will include the development and testing of an easy-to-use quality measurement tool.
Check out the book on Quality Measurement in Family Planning: Past, Present, Future that resulted from the Bellagio Conference on Quality in Family Planning, held in October 2015. Read about the BellagioCenter Conference on Quality in Family Planning, held in October 2015. Read the briefing paper on quality.
If you would like to learn more about our family planning quality research activities, please contact our Director of Research and Technical Assistance.
METRIC: ABORTION SERVICE QUALITY
Millions of women worldwide need access to safe, high-quality abortion care. Recent estimates indicate that more than 56 million abortions are performed per year, with nearly 88% occurring in developing countries. Despite progress in the provision of safe abortion, significant disparities remain in access to and quality of abortion services around the world. Currently, no consistent, valid, and reliable method exists to measure quality in abortion care, learn from the results, and/or use that information to improve quality of care.
There is a growing desire for a common suite of measures that prioritize women’s needs, preferences, and experiences in order to evaluate quality of abortion care. These measures could be used by governments and policy makers who wish to strengthen quality in healthcare, providers who wish to strengthen their quality of service, and donors who seek to support evidence-based interventions in abortion care.
Develop a set of standardized, actionable, simple, timely, and valid metrics to measure and improve the quality of abortion service provision using a human rights and client-centered lens.
Metrics for Management, Ipas, and Ibis Reproductive Health are leading a collaborative to develop abortion service quality metrics. We began the process through a consultative meeting that brought together a broad cross-section of stakeholders for a participatory discussion. This was the first critical step to develop a process to build, pilot, validate and promote a suite of common measures of abortion service quality.
Project development is underway.
METRIC: MATERNAL HEALTH QUALITY
High quality maternal health care delivery is critical to the health and survival of pregnant women and newborns, yet there is limited agreement on the definition of quality in maternal healthcare or how to measure it. We see significant variations of quality of maternal health care across facilities. Better data and better methods to measure quality are needed in order to develop and implement effective solutions.
The World Health Organization has identified nearly 400 indicators to measure the quality of maternal health services. Metrics for Management seeks to reduce that number to create an easy-to-use metric that is applicable in LMIC settings.
Create a measure of maternal health quality that combines strong evidence with real-life utility to improve patient health outcomes.
Metrics for Management is reviewing existing indicators of maternal health in a process to reduce the total number of indicators. This reduction process will help us understand which indicators have the largest impact on maternal morbidity and mortality. We will then assess the real-life utility of these indicators as we work to develop a metric that is useful to facility management.
METRIC: PERSON CENTERED MATERNITY CARE
The concept of Person Centered Maternity Care (PCMC) focuses on the patient experience as an integral part of high quality maternity care. Studies have shown a strong relationship between the patient experience and technical quality, as well as in improving the demand for maternity care services (antenatal, delivery and postpartum care). It affirms that maternity care should be free of abuse, and then extends the concept to also emphasize the patient’s experience with regard to communication, respect, dignity, and emotional support.
There is a growing emphasis on the patient experienceas a key component of quality maternity care, yet there are limited ways to measure or assess this experience. With a growing number of global initiatives focused on continuing to reduce preventable maternal and neonatal deaths, there is a need for a standard, validated measure of patient experience that is both culturally relevant and broadly applicable. Such a measure would complement and be implemented in conjunction with assessments of technical quality of maternity care. In response to this need, Metrics for Management is developinga simple-to-use scale of person-centered maternity care that is valid in multiple developing country contexts.
Create a scale for Person Centered Maternity Care that is easy to use and valid in multiple low- and middle-income country contexts.
Using data collected by researchers at the University of California, San Francisco (UCSF), and expert opinion on the most important components of person centered maternity care,Metrics for Management shortened a previously published30-item PCMC scale. UCSF researchers developed the original scale in Kenya, and applied it in Ghana and India. We simplified the scale using expert opinion alongside robust mathematical techniques to identify those scale items that are most important to capturing person-centeredness in maternity care. Next steps include additional validation of our short scale in other countries, and with diverse patient populations.
Report in progress.