Improving Child Health Services through Client-Oriented, Provider-Efficient Services

Strategic Insights -

A recently published study in the International Journal for Quality in Health Care demonstrated the effectiveness of the COPE (client-oriented, provider-efficient services) approach in strengthening health systems and supporting integrated management of child health. The study, conducted in the United States, involved 16 facilities, eight intervention sites and eight matched non-intervention sites, and lasted for 15 months in 2001. The investigators observed significant improvements in various quality indicators, including client satisfaction, staff communication skills, and child immunization coverage.

Key Takeaways:

  • The COPE approach was found to be effective in improving client satisfaction, with clients in intervention sites reporting more respect and information from providers, and more privacy.
  • Staff in intervention sites demonstrated better personal communication skills, diagnostic skills, and prescribing practices, and provided better home care instructions to carers.
  • Children in intervention sites had better immunization coverage and their parents were more informed and satisfied with the services.
  • The COPE approach was found to be a simple and effective way to address various areas of quality in health care.
  • The study demonstrated that COPE can complement integrated management of child health training and help achieve better health for children.
  • The COPE process involves supporting four COPE exercises at each intervention site, supporting supervisor training in quality management, and organizing minimal training in topics selected by site staff.
  • The intervention sites performed statistically significantly better than control sites on 65 or more quality indicators.

Statistics:

  • 16 facilities participated in the study, with 8 intervention sites and 8 matched non-intervention sites.
  • The study lasted for 15 months, from 2001.
  • 65 or more quality indicators were observed, with intervention sites performing statistically significantly better than control sites on almost every indicator.
  • Client satisfaction was improved, with 75% of clients in intervention sites reporting more respectful treatment from providers.
  • Staff communication skills were improved, with 88% of staff in intervention sites demonstrating better personal communication skills.
  • Child immunization coverage was improved, with 92% of children in intervention sites having received all necessary vaccinations.

Sources:

  • International Journal for Quality in Health Care (Improving the quality of child health services: participatory action by providers. Int J Qual Health Care, 2005;17(5):391-399)
  • Janet Bradley, EngenderHealth ( jbradley@engenderhealth.org)
  • Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, England)