Conclusion

Regular activities to improve health care are increasingly expected on the part of managers, clients, the community, donors, and payers as a routine part of delivering health care services. PEPFAR recently issued the PEPFAR Quality Strategy to guide countries and implementing partners to improve PEPFAR-funded HIV programs and the services they provide (PEPFAR 2014).

As the global community and individual countries rally to meet the MDGs, the importance of quality for achieving the MDGs and eventual post-MDG goals is increasingly recognized. Global plans, such as the Every Newborn Action Plan endorsed by the World Health Assembly in the spring of 2014, are actively seeking to define measurement and implementation strategies that incorporate a strong focus on quality. Indeed, improving quality is one of Every Newborn Action Plan’s five strategic priorities.

As illustrated in the country case examples throughout this brief, many lessons are being learned about how to improve quality and coordinate life-saving health care services from the household to the health post to the health center to the district and regional hospital. Applying improvement approaches to continuously strengthen and link community services to the formal health system is at the heart of achieving coordinated equitable, client-centered, effective, and safe health care services to end preventable deaths and achieve better health outcomes.

A Global Seminar on Making Health Care Better in Low- and Middle-Income Countries held in Salzburg, Austria, in 2012 brought together 58 health care leaders from 33 countries to synthesize lessons learned, discuss challenges and opportunities, and recommend next steps to stimulate a global movement for improvement in the quality and safety of health care (Massoud et al. 2012). The seminar participants issued a Call to Action (The Salzburg Statement) for governments, health policy leaders, communities, development partners, non-governmental organizations, health care workers, and patients to improve quality of care, urging the following actions:

  • Health policy leaders to adopt and promote quality improvement as a cornerstone for better health for all
  • Clients and patients to be empowered and at the forefront of their country’s shared vision for better health for all
  • Communities to actively advocate for quality health care as part of their rights and responsibilities
  • Health care workers to continuously improve the delivery of expert and compassionate care to patients and their families
  • Those providing technical assistance in global health to incorporate evidence-based improvement methods in their work
  • Development partners to invest in approaches that drive sustainable context-specific improvements in global health
  • Governments to be accountable for the improvement of health care through legislation, policies, and necessary resources

All need to a role to play in making health care better.