Maximizing
Access and Quality of Services |
What is the MAQ Exchange?
The MAQ Exchange is a means of engaging USAID missions, their country counterparts, USAID/Washington and collaborating agencies (CAs) in a dialogue aimed at developing or improving programs that reflect MAQ principles and practices. It is a product of the MAQ Initiative which for several years has joined the efforts of USAID, CAs and host country partners to collect field expertise and to apply state-of-the-art methods to maximize access to high quality family planning (FP) and other selected reproductive health (RH) services through a client-centered approach.1
The Ghana MAQ Exchange
Ghana was the first country to host a MAQ Exchange after pilot tests were held last July in Romania and Tanzania. From 15-17 February, 30 participants met in Cape Coast with five MAQ facilitators. The combination of reproductive health professionals who gathered at the Ghana Exchange created a stimulating atmosphere in which a wealth of new information, data and lessons learned on improving access and quality could be shared. Participants in the Ghana Exchange included Ministry of Health representatives from the central, regional and district levels, primary CAs, nongovernmental organizations (NGOs), United Nations Population Fund (UNFPA), and the USAID/Ghana mission. The MAQ facilitators in Ghana were Jim Shelton and Michelle Heerey from USAID/Washington, Pape Gaye from INTRAH/PRIME in Lomé, Togo, JHPIEGO consultant Mark Gibson, and Joseph Amuzu of USAID/Accra. USAID and INTRAH/PRIME cosponsored the workshop.
The Exchange process began with a needs assessment, conducted by the facilitation team, in which the mission staff played an active role. The needs assessment included in-country site visits. Data collected enabled the facilitation team to tailor the MAQ Exchange curriculum and exercises to meet the specific needs in the Ghana program.
The centerpiece of the Exchange was a 3-day interactive and results-oriented workshop conducted by the 5-member facilitation team who brought with them a range of technical, programmatic and training expertise. The MAQ Exchange workshop focused on four themes: overcoming barriers to quality, client-centered communication, selected RH integration and application of MAQ principles and practices.
During the course of the workshop, the mission and its partners drafted action plans using the Synergy of Interventions framework pictured on the next page. (See Figure 2.)
High Level of Commitment
The three regions represented at the Ghana MAQ Exchange (Eastern, Brong Ahafo, and Ashanti), the Ministry of Health and the USAID mission all made commitments to take concrete actions that will increase access to and the quality of family planning and selected reproductive health services. The high level of commitment demonstrated by all the MAQ Exchange participants made this event a big success.
Dr. James Shelton, Senior Medical Scientist, USAID/Washington, presents certificates to participants at the closing of the MAQ Exchange in Ghana. How Can USAID Missions in Francophone West Africa Sponsor a MAQ Exchange?
Contact Michelle Heerey, coordinator of the MAQ Working Group in Washington, DC, telephone 202-712-4548 or e-mail mheerey@usaid.gov. The MAQ Exchange materials are currently being translated into French, and Michelle can assist you with coordination, scheduling, content and selection of master trainers to tailor the MAQ Exchange to meet national and mission needs.
Figure 2. Synergy of Interventions
1 MAQ Exchange Brochure. 1999. USAID: Washington, DC.
Highlights of Action Plans Proposed During the Ghana MAQ Exchange
Eastern Region: Disseminate and apply service delivery guidelines (SDGs)
Use regular quarterly meetings to distribute and begin training in use of new SDGs.
Revise supervision and monitoring to reflect areas of priority in effecting behavior change related to application.
Orient/inform the community of new SDGs. Inform the community of client rights (no age restrictions, etc.)
Allocate regional and district level funds for this work (regional director is committed).
Brong Ahafo Region: Engage providers in the process of change needed to improve services
Specific goal: Address provider biases, skills/knowledge and lack of clarity in job duties.
Use situation analysis data and focus group discussions to assess provider perspective regarding barriers to quality service provision.
Refine job descriptions/expectations.
Create new job aid: easy-to-use checklist of eligibility criteria for FP methods.
Request AVSC assistance with the Client-Oriented, Provider-Efficient (COPE) approach at facility level. Focus on improving privacy for counseling.
Provide rewards for outstanding performance of both health workers and community groups (e.g., certificates/TVs/ locally donated goods)
Allocate regional and district level funds for the initiative.