Programme description

Title: Improvement of quality management in public health care
Commissioned by: Bundesministerium für Wirtschaftliche Zusammenarbeit und Entwicklung (BMZ)
Country: Guinea
Lead executing agency: Ministry of Health
Overall term: September 2001 to October 2009

Context

The population make little use of Guinea's state health facilities. The health staff work under poor conditions and the facilities are inadequately equipped. Low salaries, poor infrastructure and a lack of instruments and medicaments also impair the motivation and commitment of the staff in their daily tasks.

Objective

The quality of the health system is being sustainably improved.

Approach

With the support of GTZ, Guinea's Ministry of Health has developed a quality competition to review health facilities, identify weak points and develop possible improvements. The facilities and health authorities take part in the "quality competition" voluntarily, which comprises various stages oriented to universally recognised quality management strategies. The way in which Guinea's health system operates is evaluated and improved in various areas on the basis of these criteria. With this "quality competition" the Ministry of Health examines, for instance, the sectoral and management competence of the individual facilities, customer and patient satisfaction, and receives suggestions for modifications from health service staff. The quality check includes not only the self-evaluation of the participating facilities, but also an external analysis and the development of proposals for improvement. GTZ is backing up the competition at all stages together with the Ministry. It prepares the participants for the competition and subsequently supports them in improving their services. To this end, GTZ first develops plans for improvement jointly with the facilities and then provides both personnel and funds for implementing these. In order to involve the entire health system in this process, GTZ also advises the authorities and the Ministry. GTZ discusses the results of the competition with the persons bearing responsibility for policy in the government and in the individual regions.

Results achieved so far

The growing interest in the quality competition in Guinea is reflected by the annual increase in the number of participants. Whereas in 2001 a total of 128 health facilities from four regions took part, by the third cycle in 2005 the numbers had already grown to 180 facilities from five regions and the capital city Conakry. In the meantime a number of international partners such as the EU, French development cooperation organisations and the World Bank have joined this process and are supporting it financially. With the aid of GTZ International Services and the World Bank, the quality competition is to be introduced in all regions of Guinea in future.
The World Health Organisation (WHO) evaluated the competition in 2005. There are positive changes in both the work of the health staff and patient satisfaction. The patients felt the health staff were friendlier and treated them more politely. Patients were given information on their treatment and the course of their illness. Hygiene in the facilities had also improved. This has led to greater satisfaction with the health facilities among the population and to greater use of the services. The quality competition also made it possible for the population to participate in improving the health system, for example where municipalities involved representatives of the population in the administration of the health services. Rural municipal councils took over the salaries of additional staff employed, and many citizens supported the facilities with donations or by helping to renovate buildings.

Address

Programme Santé et lutte contre le sida (PSS)
B.P. 4100
Conakry, Guinea