F6: Using QI approaches to tackle health inequalities in maternal and neo-natal care


Friday 12 Apr | 15:00-16:00


Format: Workshop
Stream: Population
Content filters: Recommended for those new to quality improvement; Recommended for those
working at system level in QI



PART 1: Improving quality of immediate newborn care in primary health care in Nigeria


Neonatal mortality in Nigeria was 37 per 1000 live births in 2017 (MICS, 2016/17). Prevention and management of drivers of neonatal mortality are non-effective and uncoordinated partly due to weak human resource for health (ENAP, 2016). The Government of Nigeria instituted the 2018 Task-shifting and Task-sharing Policy allowing community health extension workers to be skilled birth attendants.


The USAID-funded Integrated Health Program in 2019 provided technical assistance to strengthen service delivery, including essential newborn care, through leveraging QI for input optimization.


States developed QI implementation plans, established working groups, set state-wide aims, QI teams received coaching, participated in peer learning sessions to monitor performance and conducted PDSA cycles.


As a result of this session, participants will be able to:



  • Understand QI as a part of a comprehensive health systems approach

  • Have a model of QI to improve immediate newborn care in low resource settings like Nigeria

  • Learn about the success factors for implementing QI at a large scale


Jenny Mwanza Palladium Group, Nigeria



PART 2: Improving breastfeeding among urban Western Australian aboriginal infants through CQI


Breastfeeding rates in Australia, especially for Indigenous babies, are falling short of targets. In 2018-19, 84.9% of Aboriginal infants were breastfed, but only 18.9% exclusively for the first six months. Western Australia mirrored these trends. Disparities emerged between urban and rural Aboriginal mothers. A 2014-15 survey showed breastfeeding rates were 73% in major cities compared to 91% in remote areas. Qualitative data from health service providers highlighted challenges like insufficient education and early discharge. CQI methods, involving teamwork and system enhancement, have potential to enhance maternal and child health services to improve breastfeeding rates. We will present our Interrupted time series study which utilises CQI as the intervention.


As a result of this session, participants will be able to:



  • Understand the inequities Aboriginal people experience in Australia

  • Understand the role CQI has in delivering improved care to Aboriginal and Torres Strait Islander peoples

  • Understand and learn how to manage a CQI intervention delivered within Primary Health Care


Dan McAullay Edith Cowan University, Australia