Quality of care: Measuring a neglected driver of improved health

Akachi, Yoko; Kruk, Margaret E

doi:10.35188/unu-wider/2017/361-5

Cited by 23 publications

(33 citation statements)

References 36 publications

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“…The need to have locally relevant and appropriate measures and standards was perceived to be a facilitator of success not only in SA, but the broader LMICs. The importance of context, both in accounting for local settings when designing systems and measures, and in sustaining their utilisation have becoming increasingly recognised as central to overall success in the LMICs …”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude and practices of clinical quality and performance assessment among emergency medical services personnel in South Africa: A mixed methods study

Howard

Cameron

Castrèn

et al. 2019

Emerg Medicine Australasia

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Objective: Deficits in healthcare quality are becoming an increasing concern globally. Within the low-to middleincome country (LMIC) setting insufficient quality has become a bigger barrier to reducing mortality than insufficient access, where 60% of deaths from conditions amenable to healthcare, are due to poor quality care. Measuring quality is key towards improving the effectiveness of healthcare in this setting. Methods: A mixed methods sequential-explanatory study was conducted, to describe what Emergency Medical Service (EMS) practitioners understood about quality systems within the LMICs, using South Africa as an example. Part 1 consisted of a cross-sectional survey (n = 169), the results of which were utilised to develop a semistructured interview guide for Part 2. Interviews of participants from Part 1 explored the results of the survey (n = 20) and were analysed through content analysis to develop core categories central to the understanding of quality assessment in the LMICs. Results: Despite relatively poor knowledge of organisational-specific quality systems, understanding of the core components and importance of quality systems was demonstrated. The role of these systems in the LMICs was supported by participants, where the importance of context, system transparency, reliability and validity were essential towards achieving ongoing success and utilisation. The role of leadership and communication towards the effective facilitation of such a system was equally identified. Conclusion: Within EMS, quality systems are in their infancy. It could be argued that this is somewhat more pronounced in the LMICs, where knowledge of organisational quality systems was found to be poor. Despite this, there was a strong general understanding of the importance of quality systems, and the role they have to play in this setting.

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Section: Discussionmentioning

confidence: 99%

Knowledge, attitude and practices of clinical quality and performance assessment among emergency medical services personnel in South Africa: A mixed methods study

Howard

Cameron

Castrèn

et al. 2019

Emerg Medicine Australasia

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“…Van Den Broek & Graham concluded that the quality of care is a "neglected agenda" (15) in an effort to improve maternal and neonatal health and end preventable deaths. After almost a decade, Akachi & Kruk affirmed that the quality of care is a "neglected river of improved health" (21) The current status of studies on the measurement and improvement of the quality of maternal and newborn care also attest to the fact that quality of care has been neglected over time. Initially, both quality of care and access, coverage…”

Section: Facility-based Care: the Focus In Ending Preventable Maternamentioning

confidence: 99%

“…Telling 'the story' involves reviewing a wide range of aspects of care such as the structure, process, and outcome of care and using routinely collected perinatal data as the source of information and basis for actions to improve the quality of care at in the perinatal period. The perinatal data are analysed and interpreted to provide information that could and utilization of services have received little attention until the MDGs were signed in 2000, and there was an explosion in research on coverage, access, and utilization of health services in low-income countries which were not witnessed in researches on the quality of care (21). This is depicted in fig.…”

Section: Towards Quality Improvement In the Health Facilities: Tellinmentioning

confidence: 99%

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Pragmatic approach to halt preventable maternal and neonatal deaths in Nigeria

Komolafe¹,

Irinoye²

2019

Research Journal of Health Sciences

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The objective of the paper is to promote a pragmatic approach to stem high maternal and neonatal mortality in Nigeria as it is becoming increasingly evident that ending preventable maternal and neonatal deaths goes beyond counting the numbers. Methods: A literature search was performed of Pub Med, HINARI, Google scholar using keywords in the review to build a set of search terms. Reference lists of all the included studies were scanned to identify additional relevant studies. Results: Facility-based death review, review of near-miss and clinical audit are quality improvement methods and on their own are health care interventions. Conclusion: Though findings from reviews and audit provide actionable information, the commitment of health care providers to act on the information is key to achieving the purpose of reviews and audits. There is need to invest in health system researches that focus on quality improvements in maternal and neonatal care in Nigeria.

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“…However, the significant gains achieved in maternal and neonatal mortality were not sufficient to help the country achieve Millennium Development Goals 3 and 4 (9). Therefore in the context of Sustainable Development Goal 3 (10), it is essential to focus on the provision of high quality care during childbirth to reduce adverse maternal and neonatal outcomes (11,12). This requires a focus on private as well as public sector healthcare facilities.…”

Section: Introductionmentioning

confidence: 99%

Quality of maternity care provided by private sector healthcare facilities in three states of India: a situational analysis

Tripathi¹,

Srivastava²,

Memon³

et al. 2019

Preprint

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Background Better quality of care around the time of childbirth can significantly improve maternal and newborn survival. In countries like India, where the private sector contributes to a considerable proportion of institutional deliveries, it is important to assess the quality of maternity care offered by private sector healthcare facilities. This study seeks to fill that information gap by analysing baseline assessments conducted for the Manyata program, which aims to improve the quality of maternity care at private facilities. Methods An observation checklist based on 16 clinical standards endorsed by the Federation of Obstetric and Gynaecological Societies of India (FOGSI) was used to assess 201 private sector healthcare facilities in Maharashtra, Jharkhand, and Uttar Pradesh. Data on facility characteristics came from profiles completed when facilities enrolled in Manyata. Differences in the mean number of standards met were analysed by facility characteristics and the availability of essential supplies. Results 47.1% of all nursing staff engaged in maternity care services at these private healthcare facilities were unqualified. The mean number of clinical standards met by facilities was 3.2 (SD 2.4). Facilities with a monthly delivery load between 20 and 50 met a significantly higher number of standards, as did facilities that had more than 70% of essential supplies available. Both of these factors were also significant in a multiple linear regression analysis. Conclusions The overall quality of maternity care in private healthcare facilities is poor in all three states, especially for clinical standards related to management of complications.

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Quality of care: Measuring a neglected driver of improved health

Cited by 23 publications

References 36 publications

Knowledge, attitude and practices of clinical quality and performance assessment among emergency medical services personnel in South Africa: A mixed methods study

Knowledge, attitude and practices of clinical quality and performance assessment among emergency medical services personnel in South Africa: A mixed methods study

Pragmatic approach to halt preventable maternal and neonatal deaths in Nigeria

Quality of maternity care provided by private sector healthcare facilities in three states of India: a situational analysis

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