Models of Quality Improvement in Health Care


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Question :

This assessment will cover following questions:

  • Explain principles and models of quality improvement in health care pertaining to public health.
  • What are the ways that contributes in improving health and reduce inequalities using good governance?


Answer :


Maternal mortality has been referred to the deaths of pregnant ladies while or during the delivery or during the post-pregnancy duration. This is irrespective of the place as well as the time of the pregnancy which can be triggered from any type of cause associated to the pregnancy or may be related to its management (Moucheraud and, 2015). Infant's mortality on the other hand related to the death or less management of the mother during the course of pregnancy which ultimately leads to the death of infants under the age of 1. Angola and Nigeria has been considered as the two countries with highest rate of infants and maternal deaths respectively.

The essay will focus on the quality improvement methods of infants and mother during pregnancy to reduce their mortality rate. Critical analysis of the quality area and governance structure will be discussed. Different outcomes and impact of inequalities will also be evaluated and interventions will be mentioned accordingly.


1)Relevant quality improvement methods are introduced and applied to infants and maternal mortality

The rates of mortality in infants and maternal have been increasing day by day due to low quality of life and factors like education, health status, economic conditions, literacy rate, environment and society. The countries like Angola and Nigeria have largest number of deaths in mothers and infants due to mental, physical, social and behavioural heath state. Some of the improvement quality methods which has to be adopted for improving and maintaining the well being of both mother and child so that they can live healthy life. One of the quality improvement method may be preventing defects in the birth, as defects in birth are now a day's major cause of maternal and infant mortality all around the globe especially in Angola and Nigeria. There are several kinds of defects in birth, and they might happen in all pregnancy. The are various things a pregnant woman could do to reduce the peril of several birth defects, for instance getting adequate folic acid before and in mid pregnancy to reduce neural defects in tube (Beaumont and, 2015).

As observed that by receiving preconception as well as prenatal care during pregnancy, mother's health, surroundings, and experiences effect how fetus grows and course of pregnancy. By taking care of themselves before and in mid pregnancy, a mother can implement ways to minimize the child's risk of various major reasons of infant and maternal mortality, which includes defects in birth, preterm birth, birth low weight, firm pregnancy complications. These steps to enhance the health a woman should not wait till the time of their pregnancy. Achieving health weight, eating proper diet etc. all these steps can help a woman to reduce the maternal mortality as well the risk of infant mortality at the time of pregnancy. By creating a benign Environment for infant sleep it can lower SIDS which stands for Sudden Infant Death Syndrome. SIDS can be explained as the quick, inexplicable demise of a newborn littler than age of 1 year and which remains mysterious even after various deep investigation. SIDS is one of the major causes of maternal and infant mortality all over the world. SIDS is a form of death under the umbrella of reasons of demise called SUID. The SUID includes different sleep-related reasons of infant and maternal death, such as infections, accidental suffocation, vehicle collisions and other root causes. While there is decline in the SIDS rates in the past few years, other sleep-related reasons of infant mortality are increasing. Unintended injuries are another reason of infant death all over the world. There are conducts to reduce the peril of SIDS as well as various sleep-related reasons for death of infant. For instance, always keeping a newborn on their back for sleep as well as keeping newborn's sleep zone free from soft items, crib bumpers are essential conducts to minimize the newborn's risk. The NICHD campaign explains various methods that parents can minimize the peril of SIDS and different sleep-related reasons of infant deaths in Angola and Nigeria.

The Exhausting Infant Screening to find concealed circumstances is an efficient improvement methods for infant screening which can find various circumstances that cannot be noticed at the period of birth, which can lead to grave disability or can also become the reason for the demise if not properly taken care of. Newborns with such kind of conditions may look completely healthy and usually come from background with no history of such condition (Evans, Goldstein and Popova, 2015). In order to accomplish this screening, some blood is taken out of infant's heel and put that blood to a special kind of paper. The blood is then examined. If any circumstances are found, proper treatment begins taken instantly. Since this program was initiated in early 1960s, the program is able to save innumerable lives by providing early finding and intercession and by refining the life of infant and their mother.

2)Critical analysis of quality area using relevant research and literature

It has been observed that the main and leading reasons behind the mortality rate of infants are mother complications during pregnancy, for instance, smoking habit of mother during the course of pregnancy may lead to birth defects and cause quick new born death syndrome. The maternal mortality occur mainly due to rigorous bleeding at the time of child birth. The deaths may also be caused by the outcome of infection usually after delivery of baby or such action may be resulted due to complications from the delivery which not only increase the number of deaths in mothers but also severly affects the quality of life in infants (Quansah and, 2015). The child has been considered as the future of any country and the health evaluation and ritical analysis of quality area must be adopted in efficient and effective manner to uplift the country as well as the family and community.;

The areas which need to critically analyse and evaluate are the maternal supplementation during the pregnancy, which will affect the life of both mother as well as the baby. The supplementation of calcium and zinc should be regulated carefully (Gülmezoglu and, 2016). The uptake of calcium should be initiated from 20 weeks of conception as it has been observed that ingestion of calcium lower the risk of hypersensitive syndrome in pregnant lady. Consumption of zinc decreses the threat of preterm birth. Overall balance of energy requirement should be in adequate amount, around 25% total energy must be in form of protein has been regareded as a necessary and essential method for preventing maternal under nutrition condition. Another analysis area should be focus on maternal infection which has a negative consequence on the perinatal outcomes and lowering mortality rate of both mother and baby efficiently. Antenatal treatments involves in immunizing the pregnant lady with tetanus toxoid to eliminated the death from neonatal tetanus by large percentage. The women having undiagnoised and untreated syphilis have huge risk of still births, thus antenatal syphilis diagnosisis is required to reduce infants deaths and neonatal mortality. For malaria prophylactic antimalarial drug can be used as an effective method to improve the birth weight and deaths of neonatal. So as to lower the intrauterine growth restriction (IUGR) which is one of the major cause of deaths and severe morbidity, methods like counting fetal movement and antithrombotic agents have ben established.

By counting the movements of foetus indicates its healthy nature, if the movements are reduced then it may signify that the foetus may be compromised. The issue of protein and energy malnutrition as well as stumpy birth weight require improvements in maternal health and prenatal care by encouraging breastfeeding and child growth and space analysis. The treatment with heparin should be avoided, as it enhances the pregnancy complications. Antithrombotic agents must be used to treat harmful blood clotting and significantly lowers the perinatal deaths as well as infants birth weight. Intrapartum care must also be monitored and has been considered as a critical area to evaluate and analyse. Labour supervision is required for management clinically and reduce prior complications (Lorenz and, 2016). The care must include delivery of parenteral oxytocin, antibiotics for eclampsia. The skills and items for manually removing placenta must be gathered around and ability to perform vaginal delivery must be present with skilled and professional doctors. Such practices must be assured as still births and infants mortality is being closely associated with difficult and troubled labour.

3)Governance structures

Governance structures are the frameworks that consist of some set legal policies and standards for the management of an organisation in order to achieve target goals and objectives. It is basically a structure that make leaders and supervisors of an organisation to improve their operations and services. It plays a most crucial role in healthcare organisations so that the treatments and other care services could be deliver properly to the patients and service users (Nagaraja, 2016). Clinical governance in healthcare organisations help in maintenance and improving public health and safety. There are no specific models to be followed in public health sectors, as they attempt to develop their own models for acquiring its clinical objectives. Winiseph care home is a healthcare organisation in Nigeria that supports and promote health of individuals in order to improve overall health conditions in country. They basically provide set programmes of some activities in order to promote health and social wellbeing of individuals (Singh, 2017). Nigeria has a high occurrence of infant or maternal mortality due to lack of education and poor health services. Thus, there is a great need in respective country to make efforts for reducing infant and maternal mortality in order to increase overall health. Winiseph care home develop some intervention programs for reducing the ratio of this particular health issue by promoting health and aware individuals regarding the negative consequences of infant mortality. A framework has been developed in the organisation that shows a structure for organising and accessing information regarding initiatives that are need to be consider that could be implement in the organisation resulting in improved maternal care. Stakeholders of the organisation are required to deliver best of their clinical practices on women that are in a period of pregnancy so that there are less chances of deaths. Providing quality care services to the women during pregnancy will reduce the chances of death of infants under the age of one year (Leloup, 2017). They provide best quality of food and nutrition to the women within the organisation that help the infant to develop and grow infants and keeping them healthy. The programme deliver the information about each and every important aspects of pregnancy such as physical exercises, food, care and many more. Reduce infant and mortality rates not only effect baby and mother but also their families including whole community. It is the most leading cause of death in Nigeria and interventions are need to be applied. A safe motherhood is a programme which could be implemented in respective organisation. The main objective of such programmes is to raise the awareness of consequences of poor maternal health and some actions to be implemented for addressing this particular issue. It is not just a public health concern, but also a human right and such efforts will help in to access safe pregnancy and infant births. The programmes in the Winiseph care home deliver the information about risks factors, health behaviours and negative consequences of poor care during pregnancy. The programme also include some activities which creates a safe an healthy environment for the individuals and some measures for preventing birth defects. They provide some important medications and other care facilities to the women so that there are less chances of any risk factors that may arise. However, the funds for such kinds of interventions are provided by government of the country weather local or state. They provide financial support to such care homes so that there could be surplus amount of resources and high educated care professionals that have skills and know clinical practices for delivering during pregnancy.

The respective organisation has built some strategies and plans for achieving their target objectives which is to reduce infant and maternal mortality in the public.;


Reducing infant and maternal mortality in countries like Nigera and Angola are the major public health issues and been increasing day by day. However, number of programmes has been developed by the government and many healthcare organisations in order to regulate and address the issues among individuals (Viens and, 2019). Decreasing the rate of maternal mortality in the country is important as it could result in extreme poverty within the country. Such programmes address inequalities for accessing to and quality of maternal, reproductive and new born healthcare services. The outcome of these programmes include better health and a decreased number of maternal health in women. The care which has been providing to the mothers in various healthcare organisations has been improved and there is a improvement in health conditions of both infant and mothers (Ado, 2016). Intervention of these program will help the individuals to be aware about the negative impacts of maternal mortality. Defects in births will e improved in the country and there will be less chances of risks that may be occur during pregnancy.

There is less discrimination and inequality in the country by implementing these programs for maternal mortality and infant mortality. The mothers will be treated equally irrespective of their caste, religion, financial status etc. Number of infections and errors during the whole period of pregnancy will be reduced and there is improvement in overall health conditions of the countries as children and women consist of more than half of the population. A high quality of parental care during pregnancy will result in improving mother's health, and health condition of the infant while their birth. Interventions for mothers during mid pregnancy such as reducing defects in birth, birth low weight, firm pregnancy and complications will help in to decrease the rate of maternal mortality as well as a better health of children. A healthy and safe environment in the organisations will help the mothers to deliver infants safely with a less chance of infections and other health conditions that could be arise.

There are number of programmes that does screening of health and overall body check-up of women who are going through pregnancy. Screening will help in to know any sort of defects or errors arising in the body that could be harmful for the infant. Health screenings of infants will results in to know any diseases or disabilities that took place during delivery. Number of trials has been done by the government as well as public health sectors within the country like Nigeria and Angola in order to minimize the occurrence of infant as well as maternal mortality. Such trials consist of measures to prevent premature birth and deaths of women during pregnancy. Improvements like better sanitation skills has been said to be effective in minimizing public health outbreaks and chances of disorders among children and mothers. The efforts which were taken for improving financial status of women families helps in to reduce mortality rates as families could be able to access o high quality of healthcare services for both mother and infant (ALIAJ and MEKAJ, 2018). Other activities such as educational programs has proved to be spread awareness amongst individuals in both rural or urban areas which is a effective strategy for reducing such kinds of major public health issues.

Current policies and standards of government focus on developing human resources such as highly educated care professionals, strengthen health information system in the country, delivery of high quality of services and many more results in low risks of infant and maternal mortality. Government play a most crucial role in this subject by combining need for education, nutrition as well as access to all sort of healthcare services need in the period of pregnancy.

Also Read- Understanding Health Illness and Well Being


From the above study, it can be concluded that health governance as well as economics play a crucial role in order to meet requirements of major public health issues. In this study, a major public issue which is maternal and infant mortality in many of the countries has been focused. Reduce infant or maternal mortality will help in to enhance the overall health of the country as well as reduce the chances of poverty. Governance frameworks and policies help the healthcare sectors and organisation to deliver a high quality of services to the women going through pregnancy and to provide proper nutrition to newly born infants. Quality improvement methods has been discussed in order to minimize the rate of maternal and infant mortality. It could be done through preventing birth defects and poor health conditions of both mother and child. Critical analysis has been done  analyzing the improvements in the quality area in the countries that has high chances of maternal and infant mortality.

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