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Maximizing Health Care Provider Performance (MAX)
Maximizing Health Care Provider Performance (MAX)
Although the provision of comprehensive abortion care (CAC) is legal in certain circumstances in Kenya and South Africa, health care personnel can face restrictive barriers that limit their ability to provide safe, high-quality care. These include harassment and stigma; conflicting beliefs and values; supply chain commodity and equipment stockouts; lack of access to training opportunities; and difficulty advocating with management for support. Through MAX, our innovative behavior change model, we took a new approach to change health care provider behavior and improve patient outcomes in reproductive health care.
The program utilized trained representatives to offer support at the provider level to address barriers and improve the quality of service delivery in Kenya and South Africa.
In addition to offering one-on-one support, MAX field representatives (field reps) created an enabling environment for providers by collaborating with them to find tailored solutions to the social, administrative, and structural constraints they faced.
The MAX program’s approach was innovative in three ways:
1) Through our focus on relationship-building with providers in the context of stigmatized environments;
2) A consistent data feedback loop which allowed providers, managers, and field reps to monitor progress and to address ongoing issues as evidenced in the data; and
3) Rigorous collection and analysis of data about the effectiveness of interventions provided by field reps to health care providers allowed us to identify the types of support that resulted in the greatest impact.
Some of the program’s highlights include:
600+
Health care providers in Kenya and South Africa received support from MAX program representatives
230,000+
Women accessed safe, high-quality reproductive health services through Catalyst Global-supported providers
150,000
Estimated unsafe abortions averted
700
Estimated maternal deaths prevented
Countries:
South Africa, Kenya
Project duration:
2012 – 2017
“The MAX project has come with elements of support for the service and for service providers, and raising the morale of … providers and their supervisors, and raising the quality of care.
You have instilled a sense of pride in caring for the least cared for; a sense of pride in the quality of work; a sense of pride in monitoring, documenting, and reviewing and analyzing the data.
You also have instilled in us an appreciation of the human rights that all women deserve; an appreciation of the need for preservation of human dignity and bodily integrity of all women irrespective of religion, race, age or gender.”
Professor Eddie Mhlanga
Chief of Obstetrics and Gynecology,
Mpumalanga Province, South Africa
Project Resources
- Evaluation of MAX (Maximizing Health Care Provider Performance): supporting health care providers to increase access to abortion care and postabortion contraception provision in Kenya and South Africa. (October, 2016). www.contraceptionjournal.org/article/S0010-7824(16)30225-6/fulltext#articleInformation
- Five years of improving abortion care and postabortion contraception: final results from the Maximizing Healthcare Provider Performance (MAX) program in Kenya and South Africa (October 2018). documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:2523ae3a-6f19-48be-8212-0ce02b4b3e5c
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