TutoratPlus/Performance Improvement Approach in Senegal
Where has OPQ been used?
- Health facilities
Key lesson:
- On the job training and mentoring keeps services running smoothly while improvements take place
In Senegal, through the USAID-funded Health Services Improvement Program (2011–2016), IntraHealth is improving the quality of service delivery with the introduction of the TutoratPlus, a combination of training methodology and optimizing performance and quality approach. The chief innovation of Tutorat is its adaptability to the provider’s specific needs, performance, and quality gaps: In contrast to Senegal’s traditional classroom trainings, the TutoratPlus process takes place in the workplace, thereby reducing the occurrence of training-related service interruptions.
The Tutorat process begins with a health facility visit by a trained mentor with expertise in performance improvement, coaching, training methodology, communication skills, maternal/newborn/child health, and family planning service delivery. After performing a rapid needs assessment, the mentor identifies gaps and strengths and shares this information with stakeholders. In partnership, the mentor and stakeholders develop a unique action plan for the health center. As providers carry out this action plan, they are supported by feedback from the mentor and their regular health district supervisors and, when necessary, tailored adjustments to the plan itself. The Tutorat process concludes as the health facility and local stakeholders assume full ownership of continuous quality improvement, monitoring, and evaluation.
Tutorat Results
A 2011 evaluation of the initial Tutorat program implemented in Senegal from 2008 through 2011 demonstrated that the methodology had improved knowledge, performance, and organization of services. New services, such as long-acting reversible contraception methods, had been integrated. Furthermore, stakeholders had become more invested in site improvement efforts, which led to improvements in working conditions and the purchase of new supplies and equipment, such as warming beds for newborns. Among the providers and stakeholders at participating health centers, the evaluation showed a 97% satisfaction level with Tutorat. These successes inspired the Ministry of Health to partner with IntraHealth in creating a more comprehensive Tutorat, called TutoratPlus, and scaling up the approach to all 14 Senegalese regions.
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