Quality improvement in health care in developing countries
Quality Improvement In Health Care In Developing Countries PRESENTED BY ROLL NO PURNIMA TIMILSINA 16 RAJESH KUMAR YADAV 19 SAGUN PAUDEL 22
IntroductionDefinition of Quality: Quality is a degree of excellence. In health care, quality is defined in the light of the provider’s technical standards and patient’s expectations. Quality is doing right thing in right way. It is a comprehensive and multifaceted concept.Quality of service:Quality of services refers to what is actually provided at the service delivery point. Quality of services is determined by how policy makers and programme managers convert their resources (staff, suppliers and physical locations) into services. The quality of services should be measured objectively. William R. finger
Quality of health care should always fulfill three points which are; It should fulfill clients or patient’s need and wants. It should give positive impact on health status. It should follow scientifically approved methods and techniques.Quality of care is views in 3 perspective; Client/community perspective Service provider’s perspective Manager/supervisor’s perspective.
Client perspective:Quality of care includes effectiveness, Accessibility, Interpersonal relation, continuity and amenities. Service provider’s perspective:It implies the skills, resources and other conditions necessary to improve health status. Health care manager/ supervisor’s perspective:Involves addressing needs of clients/ service providers through resource allocation, mobilization etc.
Objective:General Objectives: To Study Quality Improvement in Health Care in Developing Countries.Specific Objectives: To study the elements of quality of health care To study a framework for quality of care To study the Policy interventions to improve quality To study how to Measurement of quality Analyze the Economic benefits and costs of quality
Cont…….. Poor quality mental health services can violate basic human rights, lead to negative therapeutic outcomes and prevent people from enjoying the highest standard of physical and mental health. However, poor quality of care can be substantially redressed through concerted and systematic quality improvement strategies. While prescribing methods for improving the quality of mental health services is challenging, not least because there is tremendous variation in the availability of financial and human resources in different countries, providing guidance to countries to assist them to attain
Inadequate resources are a major reason for poor quality mental health care, especially in low- and middle-income countries . This needs to be rectified through additional allocation of resources, advocacy, training and other mechanisms.
‘The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge’ (Institute of Medicine, 2001)
Finding and discussion: Elements of Quality:Quality comprises three elements:• Structure refers to stable, material characteristics (infrastructure, tools, technology) and the resources of the organizations that provide care and the financing of care (levels of funding, staffing, payment schemes, and incentives).• Process is the interaction between caregivers and patients during which structural inputs from the health care system are transformed into health outcomes.
Outcomes:can be measured in terms of health status, deaths, or disability-adjusted life years—a measure that encompasses the morbidity and mortality of patients or groups of patients. Outcomes also include patient satisfaction or patient responsiveness to the health care system (WHO 2000).
Quality of health Care FrameworkPolitical InstitutionalFactors factors Demographic Health Structure Process outcome /socioecono care mic factors access The Quality of Care Cultural Social Factors Factors
QUALITY OF CARE INDEVELOPING COUNTRIES :In the fifteen years since the Alma Ata Declaration, in which the international community committed itself to providing primary health care (PHC) for all, major efforts have been made in nearly all developing countries to expand PHC services.
This has been achieved through increased resources allocated by both national and international sources, expanded health worker training, and major health system reorganization.Dramatic increases in outreach and health coverage have been reported by most countries, many of which have posted modest declines in infant and child mortality and some reductions in selected morbidity.
The process of providing care in developing countries is often poor and varies widely. A large body of evidence from industrial countries consistently shows variations in process, and these findings have transformed how quality of care is perceived. (McGlynn and others 2003).
One explanation for variation and low-quality care in the developing world is lack of resources. Limited data indicate, however, that high-quality care can be provided even in environments with severely constrained resources. A study in Jamaica, which used a cross-sectional analysis of government-run primary care clinics, showed that better process alone was linked to significantly greater birthweight. (Peabody, Gertler, and Liebowitz 1998).
Quality of care in Nepal:In Nepal, there is lack of well trained, qualified, midlevel health care workers (MLHCW) in rural areas. The lack of poor performance of providers at these health posts results in inadequate preventive and curative health services to the poor and geographically isolated population of all ethnic groups..
The lack of quality providers is a primary reason for a continued high maternal and neonatal mortality rates as well as general reduction in the quality of life due to the burden of diseases of the rural population.
Economic Benefits Individual: Physical, emotional and mental health Increased productivity (higher capacity to generate income, other things being equal) Higher quality prenatal and post natal care decreases mortality and improves subsequent school performance (labour productivity) (Van der Gag, 2000)
Social: Greater capacity to generate wealth Reduces premature death and disability (labour force and productivity up) Lower costs for providers and health insurers (lower public expenditure and possibly lower premiums)
References:• Google.com• The Quality of Care in Developing Countries, John W. Peabody, Mario M. Taguiwalo, David A. Robalino, and Julio Frenk• Quality Assurance of Health CareIn Developing Countries, Lori DiPreteBrown,Lynne Miller Franco,NadwaRafeh,TheresaHatzell