Transforming Healthcare with the Tap of a Finger

by Janet Patry, Training Facilitator, Global Business Systems, PSI @right2thrive

Just outside the center of Yaoundé, Cameroon, sits a small clinic overlooking a hilly landscape.

Two providers, employed by the ProFam franchised network of clinics, are busy managing intake for a small group of clients gathered on the terrace as they await their turn for a family planning counseling session.

Also among this group are several supervisors known as Quality Assurance Officers (QAOs). It’s their job to assess the quality of service each patient receives from his or her provider.

But instead of the usual clipboard and paper checklist, the QAOs lean over an app on a handheld tablet, scrutinizing the questions that appear on the screen with each tap of a finger. During each session, the QAO listens closely as the ProFam provider speaks with each patient, and follows the app questionnaire on the device so that feedback can be given to the provider after the session.

The app is HNQIS, an abbreviation for Health Network Quality Improvement System. Implemented in 29 countries, including Cameroon, HNQIS is used to assess the quality of care at over 8,000 health facilities.

The tool comprises four modules (Plan, Assess, Improve and Monitor) which allow QAOs to use their time and resources more efficiently to go exactly where clients and providers are—like ProFam clinics—to provide much-needed care and services. These modules work together to help QAOs conduct consistent supervision visits, immediately share targeted technical feedback with providers and monitor trends in provider performance and quality.


1. The Plan Module schedules future
assessments based on where
support is most needed (e.g.,
clinics with low-quality scores)
and where it will have the
greatest impact (e.g., clinics with
high patient volume).

2. The Assess Module allows QAOs
to assess clinical skills using
customized checklists, currently
available in 14 health areas.










3. The Improve Module displays an instant quality of care score
and is designed to promote
performance improvement through
standardized feedback and a
shareable action plan.
4. The Monitor Module displays a dashboard of graphs and tables
that highlight trends and overall
performance by facility and
health area.

In an office at the ProFam Clinic, a large, aging paper checklist is taped to the wall, cataloging questions like the ones found in the HNQIS app. “We used to fill [one of] these out every time we had a supervision visit,” a provider explained as he gestured toward the list. “We received a copy, and the success score was calculated by hand. It took a long time.”

At the same time, decision-makers at PSI’s network member in Cameroon and partner organizations can make programmatic decisions with data collected by HNQIS and linked to the DHIS2 health management information platform, where PSI pools its client service data on a global scale.

As HNQIS continues to see success, PSI is thinking big about adapting it for use at a global level. With the University of Oslo (the developers of DHIS2) and other key stakeholders, PSI can work toward integrating HNQIS as a permanent tool within the DHIS2 system, expanding it as a digital tool to fit the needs of decision makers like ministries of health and implementing partners. Whether it’s being used at clinics in the rolling hills of Cameroon, or in the hands of health ministers in capitals across the globe, the global impact of HNQIS on quality client care is just getting started.

with contribution from Elisabeth Harris, Global Business Systems Program Assistant, PSI

Hear more about HNQIS from Janet at the Women Deliver 2019 Appy Hour on Tuesday, June 4, at 6:00pm in the WD2019 Solutions Gallery at VCC West.

This article appears in PSI’s Impact magazine, released in tandem with Women Deliver 2019, as part of an ongoing conversation about putting #PowerInHerHands.

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