Quality (138) National commitment (12) Summary of discussion so far!

15 July, 2021

Dear all,

Thank you for your contributions so far around the theme of How to increase **national** commitment to quality, which is our focus for this week and next. You can review past messages here: https://www.hifa.org/rss-feeds/17

We have had several contributions from Australia, Croatia, India, Switzerland, UK, USA. Our thanks to Vikram Datta (India), Manu Gupta (India), Moses Orfega (nigeria), Tomislav Mestrovic (Croatia), Sebastian Kevany (USA), Matthew Neilson (UK), Ann Lawless (Australia), Oriane Bodson (Switzerland) for sharing your experience and expertise on these topics.

1. We have learned from Vikram Datta about the Nationwide Quality of Care Network in india and look forward to hearing more.

Neil comment: Do other countries have similar networks?

2. Manu Gupta emphasised the importance of quality data and health information system.

Neil comment: Would anyone like to comment further about the quality of data that is collected in different countries. How reliable is the data, and to what extent is it applied to drive quality improvement?

3. Moses Orfega noted the need for a 'National Quality Policy and Strategy (NQPS)' in Nigeria.

Neil comment: How is quality driven currently in Nigeria? Where are the gaps? Do other countries have an NQPS?

4. Tomislav Mestrovic noted that any quality improvement should start with an in-depth analysis of the problems related to the quality of care.

Neil comment: Are such analyses being undertaken in practice? Do they draw on the range of stakeholders?

5. Sebastian Kevany states that 'money and funding is the greatest catalyst for quality of health care services', and that an economic case can be made for quality health services. He also asks highlights corruption as a key challenge.

6. In Oriane's introduction message from WHO GLL, we are reminded about who are the national-level actors whose commitment to quality is needed? 'In general, those involved include the ministry of health team responsible for coordinating national quality improvement and patient safety efforts, senior health system and political leaders, relevant steering committees or technical working groups, and other key quality-related bodies active at the country level.'

The WHO Quality Health Services: a planning guide [ https://apps.who.int/iris/bitstream/handle/10665/336661/9789240011632-en... ] provides a range of activities that can be considered by national stakeholders... It highlights the need for a systems approach to enhancing quality of care, and for a common understanding of the essential activities at each level and among all stakeholders. The WHO National Quality Policy and Strategy Handbook [ https://apps.who.int/iris/bitstream/handle/10665/272357/9789241565561-en... ]is a useful resource to view for this discussion.

7. Matthew Neilson asks: 'How to ignite and harness the power of communities and health workers to drive national level commitment?' For health workers, suggestions include '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.'

Neil comment: I would add that community health workers are especially important here as the interface between the health systemand the community. And yet their voice is among the weakest of all (especially at national level).

8. Ann Lawless, Australia makes a number of interesting points about the two-tier health system in Australia, health service delivery for indigenous population, and privatisation (esepcially of dental care). She shares her long experience as a health activist, which has included engaging with 'ongoing reviews of national quality standards'

Neil comment: Health activism by consumers/patients is strong and healthy in Australia and many other high income countries. But I suspect that it is less developed in LMICs? Would anyone like to comment on the situation for health consumers/patient voice in their country?

We look forward to continue this wonderful conversation. The key points will be synthesised and made available through the WHO website for the benefit of others.

Best wishes, Neil

Coordinator, WHO-HIFA Collaboration: HIFA project on Learning for Quality Health Services


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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org