Quality of primary health care in developing countries: recent experiences and future directions.
نویسندگان
چکیده
Assessing and improving the quality of health care was, until recently, a low priority, both for policy makers in developing countries, and for technical agencies. The authors review the reasons for this long neglect of quality of care, which include: (i) a perceived priority of extending coverage at the expense of quality; (ii) the view that quality is difficult to assess in the absence of reliable documentation and health information systems; and (iii) the perception that improving quality is tantamount to increasing inputs, thus costly and not affordable for many countries. The authors strongly suggest that focusing on improving the process of care through quality assurance (QA) is the most promising avenue to improved quality of care in these countries. They review the current state of the art of QA in developing countries and formulate some policy suggestions: they call for a national commitment and leadership that provides a legal and institutional framework for QA and supports QA teams in the areas of setting professional standards, training, supervision, and information. The authors stress that the focus on process should not lead to a neglect of improving inputs. We conclude by suggesting future research in four broad areas: (i) development, testing and evaluation of new ways to implement QA through operational research; (ii) the links between process as well as inputs and outcomes; (iii) the relationship between quality and other health system variables, such as demand, costs, revenues and equity; and (iv) development of comprehensive quality indicators based on a score of process, input and outcome variables that allow researchers and policy makers to compare quality across time, space and different types of care providers.
منابع مشابه
Required Structures for Family Physician Program to Achieving Service Quality Dimensions in Primary Health Care: a systematic review
Background and Aim: In recent years, the family physician plan has been implemented as a main strategy of health system in Iran. Therefore, the necessity to reform organizational structure based on experiences of other countries is felt more than before. The aim of this study was to explore required structures of Family Physician Program to achieve service quality dimensions in Primary Health c...
متن کاملFuture Directions for the Organizational Readiness for Knowledge Translation (OR4KT) Tool: Response to Recent Commentaries
متن کامل
Required Structures for Family Physician Program for Achieving Service Quality Dimensions in Primary Health Care: a Systematic Review
Background: The Structure of Health System affects quality of care in family physician program. This study aimed to explore the required structures of Family Physician Program for achieving service quality dimensions in Primary Health care through analyzing country experiences. These structures will be useful in achievement of quality health care in family physician system. Methods: In this sy...
متن کاملPatient Engagement and its Evaluation Tools – Current Challenges and Future Directions; Comment on “Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review”
Considering the growing recognition of the importance of patient engagement in healthcare decisions, research and delivery systems, it is important to ensure high quality and efficient patient engagement evaluation tools. In this commentary, we will first highlight the definition and importance of patient engagement. Then we discuss the psychometric properties of the patient engagement evaluati...
متن کاملEffects of Training Health Workers in Integrated Management of Childhood Illness on Quality of Care for Under-5 Children in Primary Healthcare Facilities in Afghanistan
Background Training courses in integrated management of childhood illness (IMCI) have been conducted for health workers for nearly one and half decades in Afghanistan. The objective of the training courses is to improve quality of care in terms of health workers communication skills and clinical performance when they provide health services for under-5 children in public healthcare facili...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- International journal for quality in health care : journal of the International Society for Quality in Health Care
دوره 8 2 شماره
صفحات -
تاریخ انتشار 1996