Since the launch of the HQSS commission, our working group’s approach to describing quality has considerably evolved. Our group has three broad objectives:
- To describe quality across SDG conditions and health system platforms.
- To describe the variation in quality and its determinants
- To describe the impact of poor quality on health outcomes, utilization and out of pocket spending.
To achieve our objectives, we’ve identified cross-national data sources (e.g. DHS, SPA, MICS, SDI, PMA, SAGE, STEPS, UNAIDS, among others) and have started defining and compiling quality indicators. These indicators relate to the provision of evidence-based care and to dimensions of quality such as user experience, safety, coordination and timely action among others.
Nonetheless, there are still many challenges for our working group:
- Data types: How can we comparably describe data from heterogeneous sources such as observations of clinical consultations, household surveys, healthcare provider vignettes, clinical chart extractions etc.?
- Indicator organization: How should we present these results in a way that leads to meaningful conclusions and sheds light on areas of health systems where quality is most deficient?
Other supporting analyses are underway to help answer our objectives including:
- Estimating the global mortality burden of poor quality
- Identifying the determinants of variation in labor and delivery care quality in Kenya and Malawi
- Conducting a meta-analyss of post-operative mortality rates
And last but not least, our online “RIWI” survey on user experience and demand for quality has been piloted. More results to come soon!