Utilization of quality assessments in improving adolescent reproductive and sexual health services in rural block of Maharashtra, India

Authors

  • Sanjay L. Chauhan Department of Operational Research, National Institute for Research in Reproductive Health (NIRRH), ICMR, Mumbai, Maharashtra
  • Beena N. Joshi Department of Operational Research, National Institute for Research in Reproductive Health (NIRRH), ICMR, Mumbai, Maharashtra
  • Neena Raina World Health Organization (WHO), Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi
  • Ragini N. Kulkarni Department of Operational Research, National Institute for Research in Reproductive Health (NIRRH), ICMR, Mumbai, Maharashtra

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20181249

Keywords:

Quality assessment, ARSH, Standards, Quality of care, India

Abstract

Background: The present study was conducted with an objective to evaluate the quality of ARSH services; assess if these services met the National Standards of care and to utilize periodic program improvement recommendations through the WHO - quality assessment (QA) tools. Quality of ARSH services at twenty public health facilities in a rural block of a state in India were assessed using WHO-QA tools with a pre-test post-test interrupted time series design.

Methods: Seven standards of care addressing provision of quality ARSH services (Standard I-IV); demand generation for these services (V-VI); and management information system (Standard VII) were assessed using WHO-QA tools for five years (2009-2014). Data analysis was done using Excel scoring template developed jointly with WHO. Scores were given for each standard and to each facility.

Results: Periodic interventions resulted in improving the average facility score from 27% to 83% and overall standards score from 28% to 81% at baseline and endline survey respectively. The average scores for Standards I-IV improved from 43% 86%; for standards V–VI from 3% to 66% while for standard VII from 16% to 92% at baseline and endline survey respectively.

Conclusions: Appropriate QA and periodic evidence-informed program inputs improved the quality and utilization of ARSH services. However, community outreach activities continued to be challenging. The assessment demonstrated feasibility and usefulness of using the WHO-QA tools to monitor and improve the quality of ARSH services.

Author Biographies

Sanjay L. Chauhan, Department of Operational Research, National Institute for Research in Reproductive Health (NIRRH), ICMR, Mumbai, Maharashtra

Scientist G, Department of Operational Research

Beena N. Joshi, Department of Operational Research, National Institute for Research in Reproductive Health (NIRRH), ICMR, Mumbai, Maharashtra

Scientist  E, Department of Operational Research

Neena Raina, World Health Organization (WHO), Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi

Director, Department of Family Health, Gender and Life Course

and Coordinator, Health through the Life Course (HLC)

Ragini N. Kulkarni, Department of Operational Research, National Institute for Research in Reproductive Health (NIRRH), ICMR, Mumbai, Maharashtra

Scientist E, Department of Operational Research

References

Indian Public Health Standards, revised guidelines 2012. Available at: http://nrhm.gov.in/nhm/nrhm/ guidelines/indian-public-health-standards.html. Accessed on 22 June 2017.

Implementation Guide on RCH II ARSH Strategy For State And District Programme Managers, National Rural Health Mission. Available at: countryoffice.unfpa.org/India//Imple. Accessed on 22 June 2017.

Mehra S, Sogarwal R and Murari C, Integrating adolescent-friendly health services into the public health system: an experience from rural India. WHO South-East Asia J Public Health. 2013;2(3–4):165-73.

Evaluation of Adolescent Friendly Health Clinics initiated in Maharashtra under RCH-II. Available at: https://iihmr.edu.in/Research/Studies-Completed-Year-2009-2010.aspx. Accessed on 22 June 2017.

Chandra-Mouli V, Baltag V, Ogbaselassie L, Strategies to sustain and scale up youth friendly health services in the Republic of Moldova, BMC Public Health. 2013;13:284.

Chandra-Mouli V, Mapella E, Theopista J, Gibbs S, Hanna C, Kampatibe N, Bloem P. Standardizing and scaling up quality adolescent friendly health services in Tanzania, BMC Public health, 2013;13:279.

Mmari KN, Magnani RJ, Does making clinic-based reproductive health services more youth-friendly increase service use by adolescents? Evidence from Lusaka, Zambia, J Adolesc Health. 2003;33(4):259-70.

Nair M, Baltag V, Bose K, Boschi-Pinto C, Lambrechts T, Mathai M. Improving the quality of Health care services for Adolescents, Globally: A standard Driven Approach. J Adolesc Health. 2015;57:288–98.

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Published

2018-03-23

How to Cite

Chauhan, S. L., Joshi, B. N., Raina, N., & Kulkarni, R. N. (2018). Utilization of quality assessments in improving adolescent reproductive and sexual health services in rural block of Maharashtra, India. International Journal Of Community Medicine And Public Health, 5(4), 1639–1646. https://doi.org/10.18203/2394-6040.ijcmph20181249

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Section

Original Research Articles