Evaluating the Effectiveness of Quality Improvement Strategies in Mid-Level Private Healthcare Facilities of Lagos State: A Donabedian Model-Based Approach

Background: This study evaluates the effectiveness of quality improvement (QI) strategies in mid-level private healthcare facilities in Lagos State, with a focus on the structural components, healthcare processes, and healthcare outcomes.Employing the Donabedian model, the research aims to comprehensively assess and enhance healthcare service quality in these facilities.Methods: A before-and-after study design was employed, involving a baseline assessment of 321 health facilities and endline assessment of 239 healthcare facilities, and a subsequent 10 -12-month quality improvement intervention.Data were collected using facility assessments, client exit interviews, and interviews with key stakeholders.The analysis included a before and after analysis of the structural components, healthcare processes, and healthcare outcomes. Results:The study demonstrates positive outcomes in mid-level private healthcare facilities in Lagos State following quality improvement (QI) interventions.Structural components, including, improved equipment availability, and enhanced compliance with standards, showcased significant improvements.Renovations and heightened registration compliance further underscored commitment to regulatory standards.Challenges in service availability, particularly in family planning and laboratory services, were identified.Importantly, the implementation of a QI scoring system revealed an overall positive impact, with the average score rising from 69% to 74%, signifying enhanced quality across diverse priority areas.