Publication

Improving Quality of Care in Low- and Middle-Income Countries: Workshop Summary


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Note: Proceedings contain the opinion of the presenters, but do NOT reflect the conclusions of the Health and Medicine Division or the National Academies. Learn more about the differences between Reports and Proceedings.

Momentum for universal health coverage has underscored the problem of poor quality care in low- and middle-income countries. While concern with access to services sometimes overshadows interest in the standard of the services provided, unsafe care is a leading cause of disability-adjusted life years (DALYs) lost worldwide. As governments and donors spend more on health, they want to ensure that the services they pay for are safe and effective and, therefore, have more reason to invest in quality improvement.

Quality of care is a priority for U.S. Agency for International Development (USAID), but a lack of evidence has constrained the ability of the agency and its partners to make informed choices. With investments in quality continuing to grow, there is demand for more scientific evidence on the best ways to reliably improve quality of care in low- and middle-income countries.

To this end, the Institute of Medicine convened a two-day workshop on January 28–29, 2015, focusing on the six methods that currently make up the majority of USAID’s investment in quality improvement: accreditation, COPE®, improvement collaborative, standards-based management and recognitions (SBM-R), supervision, and clinical in-service training. The workshop considered how the different methods work to improve quality, when and where certain approaches might be most effective, and the best ways to measure success and shortcomings. Participants reflected on the state of the evidence and opportunities for advancing the global quality improvement agenda through policy, practice, and research.