The Relationship between the Factors Hindering Quality Improvement and the Implementation of Quality Improvement at the Palestinian Ministry Of Health- Gaza

The aim of this study is to investigate the relationship between the factors hindering quality improvement and theimplementation of quality improvement at the Palestinian Ministry of Health (MoH) facilities. The studyemployed a descriptive, analytical cross sectional design with a triangulated approach (quantitative andqualitative). Self-administered questionnaires and key informant interviews were used for data collection. Arandomized multi stage stratified sampling was used to select the eligible healthcare providers working at theMoH in two medical complexes (Shifa in Gaza and Nasser in Khanyounis) and five Primary Health care (PHC)centers (level 4). The calculated sample size was 418, out of them, 397 responded and completed thequestionnaires, with a response rate of 95%. In-depth interviews were conducted with eight key informants as asecond data collection instrument. Findings revealed that the most perceived factors hindering theimplementation of QI were top management commitment followed by organizational culture, leadership, healthinformation system, human resources management, staff training, and staff engagement. It was also found outthat there is a limited implementation of QI with percentage of (25.1%). Pearson test showed statisticallysignificant correlation between the implementation of QI and top management commitment, structure,leadership, human resource management, monitoring supervision, staff engagement and training, healthinformation system, financial support, and material resources. The researchers recommend prioritizing the QI inthe strategic plan as an approach to improve the performance and the provided healthcare services at the MoHfacilities; in addition, strengthening the role of management and leadership through dissemination of qualityculture, ensuring the resources, and investment in the training