Very pleased to see this discussion. One area I think really needs attention is how to ignite and harness the power of communities and health workers to drive national level commitment. I've seen some good examples of where this has happened in response to a scandal - for instance communities demanding better infection prevention and control after an outbreak of HIV linked to re-using of needles - but would be very interested in other examples.
We know that people want quality health services, so what does it take to translate that appetite into a case that makes sense to policy-makers? I guess this is a good example of the fact that we can't separate public health and politics; they are interdependent. And if we want to really make progress on quality we have to embrace the need to engage on a political level.
One way we can do this is to better empower and support health workers themselves to speak up. Health workers can often wield a lot of influence on the national level, but may not feel empowered to do so. How do we empower them? Share learning from other settings, connect them with peers, integrate quality within training curricula, demonstrate the value of efforts to improve quality, and engage with professional societies to advocate for change.
Communities are perhaps a harder nut to crack but I think there are some good examples of where civil society or patient groups have really pushed the quality agenda.
I'd be really interested to hear any other examples of where communities have successfully helped secure national commitment so please do share any thoughts on this.
HIFA profile: Matthew Neilson is a Consultant at WHO, based in the United Kingdom. Professional interests: Public health, quality of care, quality in FCV settings, health systems preparedness and resilience. Email address: neilsonm AT who.int