Throughout Africa, the human resources crisis in the public health system has become one of the biggest challenges in attaining the Millennium Development Goals (MDGs). In the face of difficult working environments and inadequate support, health workers are often unprepared and unable to meet the high demands placed on them; they lose motivation, become disengaged, or vacate their posts altogether.   This report describes pioneering work in Niger by the USAID Health Care Improvement Project (HCI) to apply quality improvement methods to strengthen human resources management and performance at the facility- and district-management level to improve maternal care in the Tahoua Region.   

Since May 2009, 15 health facility and 11 district management quality improvement (QI) teams have worked together with the support of the Ministry of Public Health (MOPH) in Niger and the USAID HCI Project. This work uses the QI Collaborative approach to develop, test, implement, and spread feasible strategies targeting specific human resources improvement objectives to improve maternal care services. As part of this strategic human resources management process to improve maternal care, teams aligned maternal health goals and objectives from the central to facility levels, and clarified and defined tasks and competencies for clinical staff in maternity units. Regional and district health teams continue to implement system changes while facility teams focus on improving performance and providing support to engage health workers.