For years, we’ve monitored improvements in EmONC skills and knowledge through post-tests and mentorship assessments. This gives us confidence that mentorship is working—nurses consistently score above 90% after training—but it doesn’t tell us the full story. Are these skills being applied during real deliveries? What actually happens at the bedside, in the minutes that matter most for mothers and newborns?

In 2024, we launched QuIPS (Quality Intrapartum Survey) to answer exactly that question. QuIPS tracks real-world adherence to evidence-based practices during and immediately after childbirth—things like timely oxytocin administration, appropriate infection prevention, and early initiation of breastfeeding. Managed by facility leaders, it offers a structured, reliable way to observe whether the quality we teach is the quality women actually receive

“QuIPS gives us a way of monitoring how on-the-ground training translates to real-life deliveries—helping us streamline which training is reinforced and ensuring every mother gets the best possible experience during such a challenging and emotional time.”
— Agatha Nthenya Mutinda, Nurse-midwife

Why QuIPS? A missing link in maternal & newborn quality of care

Kenya’s health system increasingly relies on data, but most available indicators focus on outcomes—mortality, complications, or service counts—not the actions that prevent complications in the first place. Traditional observation checklists are long and difficult to scale, and patient records often miss crucial details.

QuIPS fills this gap by providing a concise, digital, 50-question tool that any trained staff member can use to benchmark quality at the moment of birth. It helps counties answer:

• Are providers consistently applying evidence-based practices?
• Where are the gaps in clinical behavior?
• What needs targeted reinforcement or resources?

What We’re Learning: Early Results from Nakuru County

Our first QuIPS pilot in Nakuru provided a valuable snapshot of intrapartum care quality:

• Average provider quality score: 72%
• Uterotonic within 1 minute: 61%
• Breastfeeding within 1 hour: 78%
• Calibrated blood loss estimation: 12%
• Fundal pressure use (a harmful obstetric practice): 3%
• Deliveries conducted by students: 20%

These findings helped county leaders identify where practice deviated from national standards and sparked immediate action—including refresher trainings and discussions on procuring calibrated drapes for better blood loss estimation, a timely response amid rising PPH cases.

How QuIPS Strengthens the PULSE Data Ecosystem

QuIPS adds a crucial layer to our broader PULSE decision-support ecosystem.

While PROMPTS and DHIS2 highlight missed services and outcomes, QuIPS shows whether frontline practice aligns with what mothers should receive. Together, they give county teams a complete view—from the woman’s experience, to the provider’s behavior, to the system’s readiness.

Figure 1: A pull out of the QUIPS survey 

What’s Next

A second pilot in Murang’a is underway to refine the tool and ensure strong data quality. By 2026, we aim to deploy QuIPS across all partner counties—covering nearly a third of public facilities in participating areas. With 170,000–275,000 annual deliveries across these sites, even modest improvements in adherence could significantly strengthen safety and quality for mothers and newborns.