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Dr. M. Rashad Massoud Delivers Keynote Address at Health Conference in Romania
The impact of quality improvement interventions was the focus of the keynote address by Dr. M. Rashad Massoud, Director of the USAID Health Care Improvement Project (HCI), formerly the Quality Assurance Project (QAP), at the Policies and Business Mechanisms in the Central Europe and Russia (CEE) Health Care Sectors Conference held in Bucharest, Romania September 23-25, 2008. The presentation illustrated how implementing quality improvement (QI) into health care systems, even in countries with constrained resources, can produce not only improved clinical outcomes, but significant reductions in overall health care costs.
The presentation showed how QI changes implemented by QAP, 1999-2001, in the health care system of Tula Oblast in the Russian Federation resulted in higher rates of diagnosis of arterial hypertension (AH) at the primary care level. As a result of earlier identification and better outpatient care, AH hospital admissions dropped by 17% and associated costs by 32%. Because the cost reduction was partially offset by a 61% increase in outpatient AH care, the overall cost decrease was 11%.
Dr. Massoud also presented an example of how introduction of a relatively cost-effective measure could result in a dramatic reduction of maternal mortality in a country affected by extreme poverty and poor access to skilled care. During 2006-2007, QAP’s Essential Obstetric and Newborn Care Collaborative in Niger implemented active management of the third stage of labor to reduce the incidence of post partum hemorrhage—the country’s leading cause of maternal mortality. As a result of introducing active management, the incidence of post-partum hemorrhage at facilities participating in the collaborative was reduced by over 50%.
Download the presentation:
Improving Health Care, M. Rashad Massoud, MD, MPH
HCI Sheds Light on Attitudes and Perceptions toward Male Circumcision in Namibia
By Simon Hiltebeitel
Recent studies in sub-Saharan Africa and other regions show that male circumcision has reduced transmission of HIV from women to men by as much as 60%. Male circumcision may prove especially effective in countries with high HIV prevalence and traditionally low rates of male circumcision. In Namibia, where the circumcision rate is only about 20% and HIV prevalence is high (estimated at 20%), the Government is now assessing the feasibility of including a male circumcision component in the country’s HIV/AIDS prevention strategy. Read more.
Job Aids Improve Community Health Care Workers Use of Malaria RDTs
Volunteer community health workers (CHWs) can use malaria rapid diagnostic tests (RDTs) safely and effectively according to a study recently published by the Malaria Journal. Study collaborators included the Zambia National Malaria Control Center, USAID through the Quality Assurance Project (now HCI), and the World Health Organization (WHO). The findings are significant since many national malaria programs are now procuring large quantities of RDTs, which use finger stick blood samples to detect malaria. Training CHWs to administer these tests using job aids—pictorial guides that enhance health workers’ ability to perform tasks correctly—provides an effective low cost approach to diagnose malaria in areas with limited access to more highly trained health workers and functioning lab facilities. Many countries in Africa (where malaria is most widespread) have been reluctant to allow CHWs to handle blood because of risks of HIV transmission and concerns about whether these minimally-trained providers could accurately use and interpret RDTs. However, this 2006 study found that CHWs were able to master the skills needed to administer and interpret RDTs correctly and safely.
The article "Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training,” provides details about the job aid and half-day training program. Co-authors include Steven A. Harvey, HCI; Larissa Jennings, HCI; Masela Chinyama , Malaria Consortium; Fred Masaninga, WHO, Kurt Mulholland, URC; and David R. Bell, WHO.
 To download the article from the Malaria Journal, link to: http://www.malariajournal.com/content/7/1/160. The Malaria Journal is an open access publication so its articles are available worldwide at no charge and with no subscription required
Dr. M. Rashad Massoud Succeeds Dr. David Nicholas
 Dr. M. Rashad Massoud, URC-CHS Senior Vice President, became Director of the USAID Health Care Improvement Project (HCI) effective July 1, 2008, succeeding Dr. David Nicholas, who transitioned from HCI Director to part-time Senior QA Advisor after 26 years of service at URC-CHS. Dr. Massoud will serve as HCI Project Director and continue to lead URC’s Quality and Performance Institute (QPI). Read more.
Improvement Collaborative Results Presented at 2008 International Forum on Quality and Safety in Health Care
HCI's pioneering work to scale up quality improvements in health care systems through collaboratives was presented at the 2008 International Forum on Quality and Safety in Health Care. Held this year in Paris, the conference drew more than 2,200 delegates from around the world. Read more.
Malaria Day, April 25, 2008: “Malaria: a disease without borders”
 The Rollback Malaria Partnership (RBM) has designated April 25th as the annual day for organizations worldwide to reaffirm a commitment to rolling back malaria in Africa and throughout the world. In line with the priorities of the President’s Malaria Initiative, The USAID Health Care Improvement Project (HCI), formerly the Quality Assurance Project (QAP), supports quality improvement activities and research in Africa. Read more.
Report on Orphans and Vulnerable Children Published by UNICEF and QAP
URC is pleased to announce publication of The Evidence Base for Programming for Children Affected by HIV/AIDS in Low Prevalence and Concentrated Epidemic Countries. The working paper is the result of collaboration between the United Nations Children’s Fund (UNICEF) and URC’s Quality Assurance and Workforce Development Project (QAP). The USAID Health Care Improvement Project (HCI), the follow-on to QAP which took effect September 24, 2007, published the report for UNICEF and USAID. Read more.
Women Making a Difference
International Women's Day, March 8th, has been observed since the early 1900’s and is celebrated today with thousands of events held throughout the world to inspire women and celebrate their achievements. To commemorate International Women’s Day in 2008, USAID’s Bureau for Global Health developed a web feature entitled “Women Making a Difference,” compiling profiles about outstanding women who are making a difference in their own countries through work for USAID, its missions, and partner organizations. Read more.
A First for Nicaragua: Private Sector Organization Certified as “Mother and Baby Friendly”
 Since 1991, UNICEF’s Baby-Friendly Hospital Initiative has certified more than 15,000 facilities worldwide as compliant with the “Ten Steps to Successful Breastfeeding.” The USAID HCI Project is proud to have helped the first private sector health organization in Nicaragua to become “mother and baby friendly”. Read more.
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