Twum-Danso NA, Dasoberi IN, Amenga-Etego IA, Barker P, et al. Using quality improvement methods to test and scale up a new national policy on early post-natal care in Ghana. Health Policy and Planning. 2014 Aug;29(5):622-632.
Thirty quality improvement (QI) teams from 27 rural health facilities in Ghana developed and tested both facility-based and community-based changes to their processes of maternal and neonatal care. Over 24 months, early post-natal care increased from a mean of 15 percent to 71 percent for visits within the first 48 hours, and from 0 percent to 53 percent for visits on Day 6 or 7. Using the most effective change ideas, the policy was scaled up over two years to 576 health facilities in all 38 districts of northern Ghana. This initiative demonstrates the utility of a QI approach in testing, implementing, and subsequent scaling up a national policy in a resource-constrained setting.