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Table 4 Sample action plans around maternal child health issues developed at district performance review and enhancement meetings in Sofala, Mozambique

From: Tackling the hard problems: implementation experience and lessons learned in newborn health from the African Health Initiative

Location at health center or hospital Problem identified Immediate action plan
Antenatal Care Few women receiving malaria prophylaxis. Re-train health care workers on criteria for when to offer malaria prophylaxis to pregnant women.
Low knowledge of criteria used to administer co-trimoxazole to HIV-exposed pregnant women. Re-train health works in staging and interpretation of prophylactic algorithm.
Additional room needed for ANC visits to facilitate completion of all necessary tests and procedures. Advocate to district chief medical office to have 2 rooms available for ANC visits.
Stock-outs of mosquito nets. Advocate to the district health office to provide health facility sufficient stock to guarantee a buffer.
Delivery Services Low capacity to diagnose complicated obstetric cases. Improve diagnosis of obstetric complications via discussion of cases and practice in the delivery room. Biweekly review partographs with health facility team.
High number of premature/low birthweight births registered in previous period. Verify accuracy of data by checking the scales in the health facilities for accuracy; if not, purchase new ones.