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Fellowship Agents of Change

The ISQua Fellowship Agents of Change initiative seeks to find examples of how Fellowship Participants have been inspired by the teachings on their Fellowship journey to make changes in their workplace, country and  further afield. 

Fellowship Programme Participants have access to resources from world renowned experts in quality and safety in healthcare. We would like to give our participants a platform to share the changes they have made and also show our experts the impact their contribution to the ISQua Fellowship is having across the globe.

Introducing ISQua's Agents of Change

Nilufar Rakhmanova-Pollard, MD, MPH, Technical Advisor, Health Systems Strengthening. FHI 360

Glenn Robert,
 Professor of Healthcare Quality & Innovation, King's College London

Nilufar Rakhmanova-Pollard has shared how Professor Glenn Robert's webinar, "Using Experience-based Co-Design (EBCD) to improve patient experience and staff welbeing" inspired her and her team to implement  this innovative participatory research approach in one of their programs at FHI 360.

"Engaging clients has always been a priority for achieving positive outcomes and is often done through learning sessions and storytelling. We wanted to push this further and partner directly with clients to improve services. Inspired by Professor Glenn Robert’s webinar, “Using Experience-based Co-Design (EBCD) to improve patient experience and staff wellbeing”, we implemented this innovative participatory research approach in one of our programs at FHI 360.

In Uganda, FHI 360 through USAID’s Advancing Partners & Communities Project works with the Ministry of Health to increase access to family planning (FP) through community health workers who provide counseling on FP methods, distribute short-term FP methods, and make referrals to midwives for long-acting methods.

Experienced Based Co-Design/EBCD is participatory action research approach developed in the early 2000s to enable clients to tell the stories of their experiences from their point of view, revealing unexpected areas for improvement. Collaboration between provider and client is the cornerstone of this approach.

FHI 360 is implementing an improvement collaborative in four districts under APC. During the most recent learning session that took place in Uganda’s Oyam District in June 2017, we (with my colleagues Leigh Wynne and Fredrick Mubiru) successfully field-tested the innovative EBCD approach for community-based service delivery. At the end of the session, we assessed this approach of obtaining the perspectives of participating clients and providers. Most clients responded positively to listening to others’ stories and working on emotional mapping, and reported that they felt comfortable contributing their own thoughts and experiences.”

Our field-test confirmed that it is possible not only to get clients’ ideas on their expectations, preferences, complaints, and needs, but also that clients are willing to be actively involved in service design and improvement. 

The products of the EBCD session became five video-testimonials of the clients’ co-design ideas, which were adapted for a project facilitator guide.

EBCD is a powerful method to make clients or patients partners in the improvement journey and we will continue exploring this method further."

Nilufar Rakhmanova-Pollard, MD, MPH, Technical Advisor, Health Systems Strengthening. FHI 360

Quality Improvement Handbook: A Guide for Enhancing the Performance of Health Care Systems

Frontline health workers in low- and middle-income countries face significant challenges to providing high-quality services: inadequate staffing, wide gaps between evidence and practice, low demand for health services and too little use of data. To help workers address these problems, Nilufar Rakhmanova, a long-term ISQua Fellow and FHI360 QI Advisor with her mentor, Health Systems Director, Bruno Bouchet at FHI360, developed Quality Improvement Handbook, which offers step-by-step guidance on using evidence-based models to improve health system performance.

The handbook, provides tools and practical advice and can help individuals or teams identify opportunities for change and design appropriate improvements, in addition to testing proposed interventions, assessing progress and applying lessons learned.