By Uom Im, EQHA Provincial Quality Improvement Coordinator, PSI Cambodia and Hatha Pich, EQHA Provincial Quality Improvement Coordinator, PSI Cambodia
For Cambodians, quality healthcare can be difficult to access. Health centers are often far away from clients’ homes, and providers don’t have the tools they need to effectively screen and treat for common diseases. In Cambodia, one of the most common diseases is tuberculosis (TB). According to USAID, two-thirds of the Cambodia population are carriers for TB, and 13,000 Cambodians die annually from the disease.
COVID-19 hasn’t made the reality of TB in Cambodia any less stark—the pandemic has simply put a larger strain on the health system in Cambodia, making it harder for TB patients to access care. To change the reality of healthcare access in Cambodia, the Enhancing Quality of Health Care Activity, led by FHI360 in partnership with PSI, Meridian Group International, and the International Training and Education Center for Health at the University of Washington and mClinica, is working with health centers across the country to improve the quality of healthcare for all Cambodians, including those affected by TB, and create trust in the services provided by health centers and referral hospitals.
EQHA has worked with the Prek Chik Health Center in western Cambodia through the Quality Improvement (QI) Collaborative, which the center joined in June 2019 to improve its poorly rated implementation of TB care, especially to help implement screening for TB patients. EQHA’s QI Collaborative provides a guide for health centers like Prek Chik to enhance their performance using evidence-based models derived from improvement science.
“The Health Center previously never performed TB screening in the Outpatient Department Service,” shared Sorn Saroeun, a secondary nurse to the chief of Prek Chik Health Center.
“When starting the QI implementation with the Health Center, the EQHA team provided orientation training on the QI Collaborative. EQHA also introduced a tool called Plan Do Study Act for the Health Center staff to review health implementation and select change ideas to make improvements on some issues of the Health Center.”
After several comprehensive training and coaching sessions provided by EQHA and the Operational District, the staff of the Prek Chik Health Center has successfully implemented TB screening, which will help improve its ratings when it comes to caring for TB patients. The Health Center now screens each patient who visits the Center for TB and asks them questions about the four main symptoms of the disease: coughing, fever, night sweats and weight loss lasting more than two weeks.
Sorn added, “The EQHA team continues to provide training and coaching, especially on how to screen TB cases in the Outpatient Department Service. The training helps the Health Center and staff to properly provide TB health awareness and education campaigns in the communities.”
Sorn continued, “All the health staff of the Prek Chik Health Center promised to improve their patient records, especially for suspected TB cases.”
All suspected cases must now be registered in a TB screening book and are required to submit sputum for examination. Additionally, the Health Center staff continues conducting weekly and monthly data collection and monitoring for TB cases.
“I am very happy to see improvement resulting from the change plan for increased TB case screening. As a result of the plan, detection of TB has increased from 1.6 percent to 91.2 percent in the Health Center,” said Sorn.