Karen Department of Health and Welfare of Annual Report 2011

Karen Village Health Worker Program conducts its own census to determine its target
population because its target areas usually cannot be defined by MHC areas. A census for each
clinic area is taken once or twice a year.
Monitoring and Evaluation
At the beginning of 2011, KDHW initiated a pilot project for monitoring and evaluation of the
quality of health care during 2010 in the mobile health clinics. Review of logbooks from three
clinics of different sizes was performed for six diseases: malaria, diarrhea, acute respiratory
infection, dysentery, anemia, and worms. Each case was scored for being correct or incorrect
for diagnosis and for treatment, based on the Burmese Border Guidelines. 1 Because the
sampling was neither random nor systematic, the results cannot be generalized to more clinics.
Another logbook review will be undertaken in early 2012 for the year 2011 under the direction
of the International Rescue Committee (IRC), using random sampling. Those results will provide
estimates of the quality of care in the KDHW system.
To follow up the monitoring program, a pilot quality improvement (QI) program is being
planned for one MHC, to be initiated in 2012. QI is based on the continuous improvement cycle
of plan-do-study-act famously associated with W. Edwards Deming and the Japanese
automotive industry. 2 The first cycle will entail a visit to the MHC by a QI team formed in the
central office. The team will administer a survey to the health workers to determine whether
they usually perform diagnosis and treatment according to the Burmese Border Guidelines, and,
if not, why not. Posters or other materials to encourage correct diagnosis and treatment for
malaria, respiratory infections, and diarrhea will be given to the clinic. A QI coordinator will be
appointed from the clinic staff who will send regular reports to the QI team based on logbook
review in the clinic for the three diseases. The QI team will produce graphs and reports of the
results and send them back to the clinic so that the clinic staff can see to what extent, if any,
their care is improving. If the plan does not result in significant improvement in care, the QI
team will study the results to develop a new plan.
We thank our partners in the KMHCP:
Freunde für Asien (funding)
Burma Relief Centre (funding)
Chrestos Mission Foundation (funding)
Community Solidarity POPOLI (funding)
Burma Humanitarian Mission (funding)
Mae Tao Clinic (clinic management, training)
Global Health Access Program (funding, technical support)
Burma Medical Association (clinic management, training)
Partners Relief and Development (funding, clinic management)
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