"Allowing the community, that is, the essential beneficiaries, to take the lead": Using the perspectives of health workers to inform a contextually relevant quality improvement intervention in the Nigerian health system.

The Nigerian health system is confronted with challenges, including but not limited to incompleteness of health data, dilapidated medical equipment, and poor healthcare financing. Thus, the Nigerian health system needs to be improved. A quality improvement intervention is a systematic continuous approach that aims to solve problems in the health system and is commonly employed to support health system development. A quality improvement intervention is more likely to work if the approach fits the targeted health system, but, there is no in-depth information on how to make a quality improvement intervention fit for the Nigerian health system. Thus, the authors consulted with health workers, key actors in the Nigerian health system regarding this. Fifty-one diverse health workers (30 health care providers & 21 health service managers) participated in this qualitative survey. The age and work experience of the participants ranged from 24 to 76 years and 1 to 50 years, respectively. Thematic analysis was performed on the data, and the main findings are reported in this abstract. The findings support that there are diverse problems across all health system building blocks. Problems in a health system building block may affect other health system building blocks. Thus, a contextually relevant quality improvement intervention in the country needs to utilize a systems thinking approach. Further, the findings suggest that collaboration, government involvement, and a data-driven approach are beneficial for developing a contextually relevant quality improvement intervention. In addition to being beneficial for developing a contextually relevant quality improvement intervention, collaboration is beneficial for implementing a contextually relevant quality improvement intervention. Finally, the findings suggest that a client-centered approach and monitoring activities are also beneficial for implementing a contextually relevant quality improvement intervention. This study provides important insights into the factors that may help the planning and implementation of a contextually relevant quality improvement intervention. Future work must investigate if the application of findings to the Nigerian context results in improved outcomes of a quality improvement intervention. [ABSTRACT FROM AUTHOR]