A project by the University of Washington, in partnership with the Ministry of Health in Mozambique, has received a five-year, $2.7 million grant from the National Institutes of Health/Eunice Kennedy Shriver National Institute of Child Health and Human Development to jump-start stalled declines in child mortality by improving interventions delivered at or near the time of birth.
The grant was awarded to Dr. Kenneth Sherr, an associate professor in the Department of Global Health, and Dr. Quinhas Fernandes, Deputy National Director for Public Health at the Ministry of Health on leave and a doctoral student in the department’s Implementation Science program. The department bridges the UW Schools of Public Health and of Medicine.
The Integrated District Evidence to Action (IDEAs) project is an “audit and feedback” intervention, focusing on supporting data-driven decision making to improve application of clinical guidelines. Through systematic assessment with feedback to health professionals on their performance, clinic managers and frontline nurses can adjust their practice in real time, leading to improvements in the coverage and quality of evidence-based clinical interventions that prevent neonatal deaths.
"Resilient and robust health systems are required for better health outcomes, including addressing the major causes of neonatal mortality,” said Dr. Fernandes, who has worked as a clinician and health system leader for Mozambique’s Ministry of Health. “Implementation science is crucial to help identify system bottlenecks and improve the adoption and implementation of evidence-based interventions that can improve service quality and lead to population-level health benefits.”
The recently awarded project applies common implementation science tools to evaluate a six-year program in central Mozambique supported through the Doris Duke Charitable Foundation’s African Health Initiative that scales up a pilot intervention that led to significant improvements in data quality, service readiness and health service outputs. The current program is being implemented in 12 districts in Manica and Sofala provinces, covering a geographical area with 150 health facilities and 2.8 million residents. District management teams, supported by staff from Health Alliance International, a center of the Department of Global Health, deliver the IDEAs intervention to all public sector health facilities in their areas.
The goal is to develop a model to deliver the IDEA intervention that is led by district management teams to build a strong foundation to scale up the project nationwide.
“The field of implementation science uses methods from diverse disciplines to close the ‘know-do gap,’” Dr. Sherr said. That is, to boost the implementation and scale-up of evidence-based health interventions that lead to improved patient outcomes and, by achieving scale, population-level health benefits.
“By embedding the research into the Ministry of Health structure and applying multiple implementation science methods, the project is designed to translate research findings into policy and strategy development at the provincial and national levels, with the ultimate hope of the project implementation strategy becoming part of routine management practice throughout the country,” Dr. Sherr added.