Ensure all private providers know the standards relevant to their service offerings. The most foundational aspect of assuring and improving quality is establishing benchmark standards against which that quality will be measured. However, private providers (even those who benefit from a strong network) do not often possess written or electronic copies of key health service standards for family planning, maternal and child health, HIV, and other key health services.
Understand the incentives and motivations of private providers. The vast majority of private providers are genuinely motivated to deliver a high standard of quality in their service provision. However, they often lack a comprehensive definition of quality of care, quality assurance, and quality improvement and are not aware of recommended approaches. They tend to focus on quality measures related to patient satisfaction but not clinical competency. Private providers often narrowly equate quality improvement with training interventions, which address only some factors that affect quality of care. Understanding the incentives, motivations, and common barriers private providers face is critical to ensure quality of care approaches are designed for them.
Consider the unique needs of non-networked private providers and facilities. Organizing private providers into social franchises or provider networks (such as a faith-based or nongovernmental organization networks) are proven strategies to promote quality of care interventions. However, in many countries most providers are not organized and those who are lack the capacity to coordinate or invest in joint quality of care efforts. Locating private health providers and facilities that operate outside networks is the first challenge. SHOPS Plus used census data, registration data provided by councils and training institutions, local stakeholder informants, and community groups to identify where private providers operate. Once the project found these providers, one-on-one engagement was often necessary to encourage their participation in networking and quality of care programs.
Support the creation of a quality culture. Improving the quality of care among private providers involves building behaviors that become routine. USAID missions can consider the following when building quality cultures, which reinforce quality as everyone’s responsibility:
- Build the capacity of provider associations to do more than organize providers. Support them in effectively engaging with the public sector and serving as a resource for quality assurance.
- Design trainings that specifically target private non-networked providers, use adult learning principles, and include immediate and ongoing post-training engagement.
- Support digital data collection from private providers and the electronic dissemination of guidelines and norms widely.
- Enable access to business skills trainings as part of quality improvement interventions.