Improving Quality of Care

Progress in mortality reduction in the Region can be related to an increase in the coverage of some life-saving evidence-based interventions. It has been observed that the evidence-based interventions are often delivered with insufficient quality.

The Lancet Global Health Commission on High-Quality (2018) reports that at present the quality of services is a bigger issue than non-utilization or non-availability of care. For example, 64% of deaths in SEAR could be because of poor quality (1.9 million deaths due to poor quality compared to 1 million deaths because of non-utilization). The commission further states that poor quality of care and experience of care may lead to loss of confidence in the formal health sector and adversely impact future health-seeking behavior.

The renewed and updated Global Strategy for women’s, children’s and adolescents’ health (2016-2030) and SDG framework provide further impetus towards ending preventable mortality among mothers, newborns and children. Universal health care is a center piece for SDG 3 wherein the quality of health care is a crucial element.  Quality of care is embedded in the recently developed global frameworks like ENAP (Every Newborn Action Plan) and EPMM (Ending preventable maternal mortality).

Quality of Care is, therefore, a key focus of WHO and partners. WHO-SEARO produced the Regional Framework for improving quality of care for RMNCAH in 2015 that recommends setting up of quality improvement structures in the ministry of health at national and sub-national levels, and support implement quality improvement (QI) at health facility and hospital levels. For the latter, WHO-SEARO has prepared the regional model for QI called Point of Care Quality Improvement (POCQI) that has initially focused at the care around the time of childbirth since it is the riskiest period for mothers and newborns as maximum mortality among women and newborns as well as stillbirths are likely to happen around this time (Lancet 2015).