COPE Handbook: A Process for Improving Quality in Health Services

Engender Health


COPE, which stands for “client-oriented, provider-efficient” services, is a process that helps health care staff continuously improve the quality and efficiency of services provided at their facility and make services more responsive to clients’ needs.

Type of Document:
A set of tools, including a self-assessment guide, a client-interview guide, client-flow analysis, and an action plan. They operate as a means for reproductive healthcare staff to assess their own work, so as to identify problems in the facility and local solutions to those problems. Forms, success examples, talking points, etc.

Audience Intended:
Two types of facilitators (external and on-site) support the COPE self assessment process, which is ongoing and should engage all staff at a health facility.

Population Experiencing Stigma and/or Discrimination:
Patients, healthcare consumers.

Stigma and/or Discrimination:
Stigma (briefly, generally in connection with HIV), sex based discrimination mentioned once regarding access to services.

Assess and/or Address:

Site preparation, introductory meetings, application of cope tools (usually over 1-3 days), action plan, and then subsequent actions (including measurement of the facility’s progress over time).

Not a lot on stigma and discrimination, but emphasis on staff involvement and ownership is notable, as is the potentially on-going process of COPE and measurement of the facility’s progress.

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