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These can then be the basis for the design and conduct of training and quality assurance interventions.
Quality assurance interventions were not described in detail but ranged from individual feedback with or without a comparison with group performance, self-auditing, group meetings to training sessions.
The merging of the two projects in 1997 allowed benefitting from quality assurance interventions to ensure the effectiveness and regularity of district supervision system and improve the availability of essential drug supply before the beginning of IMCI clinical training.
The many randomised, controlled studies addressing professional educational or quality assurance interventions carried out to improve quality of care, show that active multifaceted approaches are more likely to be effective compared to passive single interventions [ 8].
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Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries.
One quality assurance intervention in Nigeria did evaluate quality of care with a pre-/post-test targeting the competency of supervisors and the efficacy of the health information system leading to large improvements in the management of simulated diarrhea cases including disease classification and treatment (86).
We also designed a control intervention, trained facilitators to deliver the interventions, and conducted quality assurance of intervention delivery.
Initial training is provided over one day for the practice nurses delivering the intervention, using a workshop approach with role-play led by a psychologist and intervention facilitators involved in quality assurance of intervention delivery.
Quality assurance of intervention fidelity will be ensured by having a dedicated Community Relations Officer who is the regular point of contact for all coalitions and schools.
The facilitators used detailed protocols for each contact with the participant and received on-going supervision and feedback from a Clinical Psychologist, informed by assessment of tape-recorded consultations, enabling tight quality assurance of intervention delivery.
Four different data sources were used to determine hospital quality: (1) The German external quality assurance: hospital treatment for selected interventions is documented for each patient based on a set of in-house related quality indicators.
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