Publication:

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

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.