The Gold Star Quality Program: Improving Care and Raising Expectations

• Background
• Strategy
• Goal
• Objectives
• Audiences
• Key Messages
• Communication Highlights
• Impact

Background

The Population Project Consortium of Egypt with TA from Johns Hopkins University Center for Communication Programs, worked closely with the Ministry of Health and Population and the Ministry of Information's State Information Service to design the largest public sector family planning quality improvement program in the world. It aimed to upgrade the quality of Egypt's family planning services while creating among the public and service providers an expectation that services through better training and supervision of health care providers and it stimulates demand by promoting these higher quality services to the public.

Strategy

An integrated approach to enhancing Access, Quality and Sustainability

• Capitalizing on the extensive family planning (FP) service delivery capacity of the MOPH with the strong communication capabilities of the SIS/IEC Center.
• Applying the PRO (Promoting Professional Providers) Approach to position, publicize, promote and reward organizations that provide quality services and to encourage all service providers to make high-quality services the norm.
• Launching a multi-channel national communication campaign to create awareness of and to enhance consumer perceptions of quality service delivered by MOPH provider clinics.
• Directing clients to Quality Improvement Program clinics identified by a gold star- a symbol of quality to be posted on the best clinics, those that have met consistently the a comprehensive checklist of 101 indicators of quality.

Goal

"Maximizing access and quality of family planning and reproductive health services to enhance family health and quality of life."

Objectives

• To improve the supply of quality services through better training and supervision of health care providers.
• To stimulate demand by promoting these higher quality services to the public.

Audiences

• Health care providers.
• Married women of reproductive age and their families

Key Messages

The campaign unfolded in three phases:

1. Promote communities to place their trust in the service delivery clinics.
   
   "Behind every door are friends and family who care about you and your family"



2. Publicize the nationwide availability and mark-of-quality of Gold Star clinic and:
• Direct clients to use the nearest clinic regularly.
• Organize intensive week-long community mobilization and advocacy activities
• "Family Health Weeks" - "Visit the Gold Star Clinics"


3. Announce the availability of "Expanded RH Services"
• Youth Services
• Family Planning
• Safe Motherhood
• RTI detection and treatment
• Early detection of cancer
• Services for Older Women

Communication Highlights

• Mass Media: television and radio spots promoting and calling attention the Gold Star clinic sites and openings, clinic providers and services.
• Community mobilization: 'Family Health Weeks', Clinic openings ceremonies, and other community events highlighting the services available.
• Motivational Materials: Signs and displays giving directions allowing easy location of the clinics.
• Promotional Materials: Posters, desk plates, and lapel pins within the Gold Star clinic to reinforce the campaign's image.
• Counseling Materials: Flip charts and method specific brochures used during counseling to help clients make informed choices.

Impact

The success in the MOHP quality initiative to date can be measured in at least six different ways:

1. by the number of certified Gold Star clinics
• 1875 from the launching date of implementation 1995 till 2000 (Egypt MOPH System Development Project (SDP) Quarterly Statistics)
2. by the increase in the proportion of users of MOPH FP services: From 30% of all FP users in 1992 up to 40% in 1997;
3. by contributing to the increase in contraceptive prevalence from 47.9% in 1995 to 56% in 2000 over four years, for the first time exceeding half of the eligible population;
4. by the high level of client satisfaction, especially with regard to waiting time, staff courtesy and the amount of FP information provided (El Zanaty et al., in press);
5. by the high levels of exposure to the campaign 8 months post-initiation, as reported by 87% of women ages 15-49 and by recognition of the Gold Star logo by 45% (Central Agency for Public Mobilization and Statistics-CAPMAS, Egypt, 1998); and
6. by the high levels of understanding among women (70%) and men (90%) that the Gold Star represents high-quality services and well-trained providers.

The success of the Gold Star approach is also confirmed at the political and community level: State Governors increasingly wanted to be involved as keynote speakers at the high profile Gold Star certifications and ceremonies, and communities took action upon decertification of their local clinics.

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