Tables

Table 1. Performance Improvement in Reproductive Health Care
Table 2. Defining Desired Performance: Correcting Common Mistakes

Table 1. Performance Improvement in Reproductive Health Care
Country, Organization, Year	Ref. No.	Goal	Result/Status
Burkina Faso Koupéla district management team (DMT) and health care facilities 2000–	66	Improve planning and supervision of DMT; improve skills of providers in maternal and neonatal health; introduce Performance Improvement process	Found gaps in DMT in planning projects, frequency of supervision, community involvement in problem solving, and dissemination of results; for supervision problem, recommended training to strengthen supervisory skills and clarify expectations.
Burkina Faso Directorate of Family Health, Ministry of Health; 1998	114	Identify needs of community-based distributors in order to add reproductive health services to their duties	Found performance hampered by lack of financial incentives, supplies, knowledge and skills, and supervision; recommended work on incentives and supervision before training to improve knowledge and skills.
Ghana Family Health Division, Ministry of Health; 2001–	130	Strengthen supervisory skills at Regional Resource Teams in 3 regions	Strengthening organizational support for supervision.
Ghana Ministry of Health; 2000	20	Encourage MOH providers to follow infection prevention guidelines	Facilitated half-day meeting; participants found 7 areas that needed strengthening, including supervision, training of managers and administrators, and standardizing procurement of bleach.
Ghana Ministry of Health; 2001–	43	Improve clinical skills of staff at training sites for nursing and midwifery preservice education	Defined measurable desired performance, observed actual performance, and analyzed root causes of performance gaps; selecting and implementing interventions.
Kenya Family Planning Association of Kenya; 2001—	164	Strengthen providers’ postabortion care (PAC) skills	Conducting performance needs assesment; defined desired performance and performance indicators.
Malawi Ministry of Health and Population; 2001–	44	Improve staff members’ infection prevention practices	Assessing actual performance.
Nigeria USAID Mission 2000	46	Assess public and NGO family planning clinics and providers in 3 states; help formulate strategy for strengthening reproductive health services	Found gaps in availability of services, supplies, clinic cleanliness, counseling skills, infection prevention, and record keeping.
Senegal Ministry of Health 2001–	44	Improve PAC services of providers at Roi Baudouin Hospital in Dakar	Analyzed root causes; selecting interventions.
Tanzania Reproductive and Child Health Section, Ministry of Health 2001—	135, 136	Assess community perceptions and ex-pectations of health care services; work with staff of Zonal Training Centres to decentralize training and improve quality of reproductive and child health services	Conducted performance needs assessment and made recommendations regarding access, environment, and quality of services; defined desired performance in eight areas to strengthen Zonal Training Centres.
Armenia Ministry of Health 2001–	86	Work with policy makers on standards of care and physicians and nurse-midwives on quality of services; inform and involve clients and communities	Carried out performance needs assessment; drafting policies and standards for reproductive health services.
India State Innovations in Family Planning Services Agency (SIFPSA); 1999	90	Help Indigenous Systems of Medicine and rural practitioners in Uttar Pradesh offer family planning services	Identified root causes of practitioners’ reluctance to offer family planning services despite training; recommended ways to address root causes, especially lack of financial incentive to spend time counseling clients.
Yemen Ministry of Public Health 1999–	131	Strengthen reproductive health care skills of community midwives (CMWs)	Carried out performance needs assessment; strengthening supervision of CMWs and opportunities for self-directed learning; establishing licensing program.
Dominican Republic Dominican Social Security Institute (IDSS); 1998–1999	91, 120	Strengthen reproductive health services offered by providers in IDSS facilities in 2 provinces	Reduced performance gaps in counseling, knowledge of reproductive health services, and provision of contraceptives.
Guatemala Ministry of Health 2000–	99, 113	Improve maternal and neonatal health care through accreditation of district hospitals, health centers, and posts in seven districts	Carrying out solutions, such as WHO-recommended practices for management of labor in hospitals; compliance of hospitals with 77 criteria increased from 11% at baseline to 40% at first follow-up survey.
Honduras Ministry of Health 2001–	38	Help MOH to license 200 public and private health facilities in Olancho province	Found problems with most performance factors; generated solutions and estimated costs and benefits; recommended strengthening supervision, organizational support, and incentives.
Population Reports