QI Story: Transforming Safe Skilled Deliveries in Taita Taveta County, Kenya


Corresponding author and presenter: Joyce Muthoni-Health Care worker, Ndilindau Dispensary Level three government health facility, Taita  Taveta County РKenya

Ndilindau Dispensary in Taita Taveta County faced challenges in ensuring safe skilled deliveries due to cultural beliefs and low uptake of maternal services. The facility, despite offering 24-hour maternity services, struggled to reach its target of 14 safe deliveries per month, achieving an average of 28%. The Quality Improvement Team initiated a project to increase safe skilled deliveries from 28% to 100% between December 2022 and June 2023.

Using the Plan-Do-Study-Act (PDSA) model, the Maternity Work Improvement Team (WIT) identified key contributing factors such as limited 24-hour maternity services, the influence of traditional birth attendants, and the absence of maternal baby packs. Implementation involved closely monitoring pregnant mothers, incentivizing referrals, securing mother-baby packs, providing quality care during delivery, and conducting community mobilization.

Results showed a remarkable improvement in safe skilled deliveries from 28% to 179% within the six-month implementation period. Client exit interviews indicated high satisfaction, and the facility reported zero complications, maternal deaths, or perinatal deaths during the project. The success led to the facility being selected for collaborative learning, showcasing the effectiveness of the PDSA cycle and commitment from leadership in improving maternity services. In conclusion, the use of Continuous Quality Improvement (CQI) approaches, particularly the PDSA cycle, played a crucial role in turning around the struggling indicator of low safe deliveries and enhancing patient safety. The recommendation is for more health facilities to embrace the PDSA cycle to improve performance and quality of care.

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