The development of hospital accreditation in low- and middle-income countries: a literature review

Abstract

<jats:title>Abstract</jats:title> <jats:p>Hospital accreditation has been transferred from high-income countries (HICs) to many low- and middle-income countries (LMICs), supported by a variety of advocates and donor agencies. This review uses a policy transfer theoretical framework to present a structured analysis of the development of hospital accreditation in LMICs. The framework is used to identify how governments in LMICs adopted accreditation from other settings and what mechanisms facilitated and hindered the transfer of accreditation. The review examines the interaction between national and international actors, and how international organizations influenced accreditation policy transfer. Relevant literature was found by searching databases and selected websites; 78 articles were included in the analysis process. The review concludes that accreditation is increasingly used as a tool to improve the quality of healthcare in LMICs. Many countries have established national hospital accreditation programmes and adapted them to fit their national contexts. However, the implementation and sustainability of these programmes are major challenges if resources are scarce. International actors have a substantial influence on the development of accreditation in LMICs, as sources of expertise and pump-priming funding. There is a need to provide a roadmap for the successful development and implementation of accreditation programmes in low-resource settings. Analysing accreditation policy processes could provide contextually sensitive lessons for LMICs seeking to develop and sustain their national accreditation programmes and for international organizations to exploit their role in supporting the development of accreditation in LMICs.</jats:p>

Accreditation as a quality-improving policy tool: family planning, maternal health, and child health in Egypt

“…The ability of the HSRP to generate its own revenues from different sources was constrained, making the program financially unsustainable in the long run [ 1 ]. In this regard, Mansour et al [ 6 ] emphasize the lack of financial resources as a major challenge to the implementation and sustainability of accreditation programs in limited-resource settings.…”

“…These results emphasize that a high, continued, level of commitment, which is a reflection of strong political will, is indispensable for the success of quality improvement interventions in LMICs in the long run. Decentralization in no way diminishes the necessity of a high level of pledge from the central government (see Braithwaite et al [ 44 ] and Mansour et al [ 6 ] for a detailed discussion).…”

“…Accreditation of healthcare providers has been established in many high-income countries and some low- and middle-income countries (LMICs) as an approach to improve the quality of care that combines the two elements of quality assurance and quality improvement [ 5 , 6 ]. There is consistent evidence that accreditation programs improve the process of care in all settings, especially those related to the quality of healthcare services [ 7 – 11 ].…”

Testing the Strength of Hospital Accreditation as a Signal of the Quality of Care in Romania: Do Patients’ and Health Professionals’ Perceptions Align?

“…Initially developed in the USA [ 4 ], the available programs increased around the world with a particular development in Europe [ 5 ] but also beyond it [ 6 ]. Recently, accreditation has gained popularity in enhancing healthcare quality in low- and middle-income countries [ 7 ]. International organizations such as the World Health Organization (through the National Quality Policy and Strategy, or the WHO Patient Safety Program), the EU Health Systems Performance Assessment Group, the European Observatory on Health Systems and Policies, or The International Society for Quality in Health Care (ISQua) have already provided nations reliable standards for health quality accreditations.…”

Developing a Thai national critical care allocation guideline during the COVID-19 pandemic: a rapid review and stakeholder consultation

“…Further, there is a high level of trust between doctors and patients, particularly in the public sector [ 29 ]. Patient trust also increases when almost all public and private hospitals have gone through an accreditation processes, being accredited or re-accredited by the Healthcare Accreditation Institute [ 30 – 32 ]. In addition, it was determined that regular review of the guideline and a transparent patient registry of what decisions are made was important to allow for future evaluation of the guide to ensure that it fits its purpose.…”