COHSASA has implemented the first phase of the Malawi quality improvement and accreditation programme and the pilot programme for three hospitals and three primary health care clinics has begun. Dr. Ziyanda Vundle and Ms. Jacqui Stewart provided a strategic orientation to 26 members of an expert group who are currently national assessors tasked with implementing the local Infection Control programme initiated by the Malawian Ministry of Health throughout the country. This training had been preceded by a high-level delegation from Malawi’s that made a three-day reconnaissance visit to COHSASA in Cape Town to gather information about COHSASA’s quality improvement and accreditation programme.
Head of Emergency Medicine, Dr Zunaid Mohammed (far left), speaks to the Malawian delegation at private hospital group Mediclinic’s new hospital, Mediclinic Cape Gate, in Cape Town’s Northern Suburbs. Pictured with him are from left: Mr Jonathan Cushing, advisor for GIZ/ the Malawi-German Health Programme; Dr. Nordeen Alide, Director of Kamuzu Central Hospital in Lilongwe; Dr. George Chitopa Mwale; Director of Clinical Services for the Malawi Ministry of Health; Carol Defty, Hospital Manager at Mediclinic Cape Gate; Mrs Immaculate Chamangwana, Deputy Director of Nursing for the Malawi Ministry of Health and Dr Anne Phoya, Director of Sector Wide Approach (SWAp) for the Malawi Ministry.
The visit was in anticipation of implementing a project in Malawi to introduce healthcare accreditation mechanisms, including the development of Malawi standards, a system-strengthening process for hospitals and clinics, and piloting of accreditation in both public and non-state facilities. GIZ (the Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH), under commission from the German Federal Ministry for Economic Cooperation and Development (BMZ) provides technical cooperation to the project.
While here, the delegation visited a range of facilities – from Mediclinic Cape Gate, which is part of the Mediclinic private hospital group, to the City of Cape Town’s Gugulethu Primary Healthcare Clinic – to consult with those already involved in a COHSASA programme about their particular challenges and triumphs in applying the accreditation system.
Carol Defty, Hospital Manager: Mediclinic Cape Gate, and a team of senior staff welcomed the Malawian delegation and shared their experiences. Mrs Defty said it was important to set incremental, bite-sized goals to meet the objectives of the programme. “You need to set targets, measure what you have achieved and then reset them. The COHSASA programme provides us with a good external process of alerting us to our risks,” she said.
The delegation then moved on to the Gugulethu Primary Healthcare Clinic, run by the City of Cape Town, in a township on the eastern side of the city.
At the City of Cape Town’s Gugulethu Primary Healthcare Clinic, acting clinic manager, Sr Dukwana Mncedikazi (left) tells Dr. George Chitopa Mwale of Malawi how she has found working with COHSASA. Deputy CEO of COHSASA, Jacqui Stewart who hosted the visit, looks on.
Liz Rose, Quality Assurance Practitioner for City Health at the City of Cape Town who has worked with many facilities in the QI programme over the years and who led the discussion said there was a common health staff reaction to the COHSASA programme, which had not changed over the years.
“It is common to experience resistance from facility staff at the beginning of the quality improvement programme but as they familiarise themselves with the contents of the standards and begin to understand and experience the value of team-work, they take ownership of the initiative.
“The staff themselves have said they are better for the experience and ‘would not have missed it for the world’. COHSASA has forced us to evaluate our work, to set standards, to strive to reach those standards and then to maintain them, It has not come easy but the blood, sweat and tears have been worthwhile as they are now a staff who hold their heads up high and who are proud of what they have achieved and take pride in what they do.”
COHSASA’s work in Malawi began in July 2013.