Quality of care in reproductive health programmes: education for quality improvement.

ABSTRACT

PIP: This review of educational efforts to improve maternity care opens by noting that education extends beyond training and is required at all levels to enhance policy formulation and improve service delivery. The first section of the article credits the Safe Motherhood Initiative (SMI) with initially advocating education as a strategy for achieving safe motherhood and traces the origins of the SMI to actions of international groups representing midwives and obstetricians/gynecologists. The next section briefly describes the midwifery training modules developed by the World Health Organization and the American College of Nurse Midwives and mentions the few distance learning manuals for midwives that are available. The article continues with an overview of clinical-skills training developed for midwives, for physicians and assistant physicians, and for traditional birth attendants. Next, the article considers the incorporation of interpersonal communication and counseling skills into training efforts and notes that newly integrated family planning/sexually transmitted disease services will require differing applications of counseling skills and, thus, will pose a challenge to medical education. The article then reviews how the provision of management and leadership training can improve quality of care as newly-formed leadership qualities provide health personnel with the initiative to tackle minor problems and improve information management. Finally, the article reviews "excellent" examples of community participation achieved in SMI programs and notes that health workers need training on how to establish successful community partnerships.