Cathy Rehfus-Wilsek, MBA, MD
1-June-2015
Quality Improvement (QI) in Percentage of
Neonatal Fevers at Majengo Health Center
Moshi Tanzania

Lecture Objectives
 Show how simple techniques of neonatal assessments
improves overall health
 Show how maternal education decrease fevers of
neonates on subsequent visits

Why Teach Neonatal Assessment
Techniques?
 Provides better care for neonates
 Allows labor/neonatal staff to detect infant
distress early
 Early detection means early treatment and
decreased morbidity
 Continued monitoring of neonates helps reduce
infant mortality rates
 An increase in neonatal care and decrease in
morbidity leads to a cost saving of healthcare
resources

Numbers Tell the Story
Previous to the introduction of Karibu Duniani, the 10 East Steps for an Initial Neonatal
Assessment, in March of 2015, the number of fevers reordered was higher than after
the implementation of the neonatal assessment and maternal education program.
26
12
6
3
15
4
1
2
28
3
14
3
12
1
4
1
3
5 5
1
0
5
10
15
20
25
30
Fever on 1st visit Fever on 2nd visit Fever on 3rd visit Fever on 4th visit
Nov
Dec
Jan
Feb
Mar
April
onatal Fever Recorded on Visits 1-Nov-14 Through 30-Apr

Numbers Tell the Story
Previous to the introduction of Karibu Duniani, the 10 East Steps for an Initial Neonatal
Assessment, in March of 2015, the average number of infants with fevers on repeat
14% 16% 16%
7% 2% 5%
-200%
4% 4% 2% 6% 2% 1%
-300%
3% 5% 11%
4% 0% 0% 0%
20% 25% 30%
16%
3% 5%
Mean Decrease
-150%
Nov Dec Jan Feb Mar April Decrease
Fevers on Multiple Visits of Neonates Born Between
1-Nov-14 and 1-Apr-15
Fever only once Fever twice Fever thrice Fever all four visits Actual Visits vs Total Births %