Working Groups

Working group 1: Definition and description

Working group 1 will propose a conceptual framework, measure quality for sentinel SDG conditions, and describe the burden of low quality. Globally, the quality of care has been under-looked in LMICs. This has an substantial impact on health and mortality:

• “Obstetric Facility Quality and Newborn Mortality in Malawi: A Cross-Sectional Study”; Hannah H. Leslie, Günther Fink, Humphreys Nsona, Margaret E. Kruk.

Substantial efforts have been made to improve care for select conditions during the Millennium Development Goals era, and now the Sustainable Development Goals era. The following articles take a look at how the quality of care for these conditions has fared:

• “Determining the effective coverage of maternal and child health services in Kenya, using demographic and health survey data sets: tracking progress towards universal health coverage.” Tropical Medicine & International Health (2017). Peter Nguhiu, Edwine Barasa, Jane Chump. 
• “Undertreatment of people with major depressive disorder in 21 countries.” The British Journal of Psychiatry (2016). Thornicroft, Graham, et al.
• “Quality of basic maternal care functions in health facilities of five African countries: an analysis of national health system surveys”; Margaret E Kruk, Hannah H. Leslie, Stéphane Verguet, Godfrey M. Mbaruku, Richard M. K. Adanu, Ana Langer. 

Working group 2: Measurement

Working group 2 will review measures of clinical effectiveness and patient experience, propose indicators of effective coverage, and develop the next generation facility survey. First start learning about quality measurement by reading this seminal paper:

• “The quality of care: how can it be assessed?”JAMA (1988); Avedis Donabedian.  

Since Donabedian’s work, there have been numerous research efforts to better measure quality. Below are some new and innovative measures of quality that we think are particularly relevant to our work:

• “Improved measurement for mothers, newborns and children in the era of the Sustainable Development Goals.” Journal of Global Health (2016). Tanya Marchant.
  
• “Use of electronic health records to evaluate the quality of care for hypertensive patients in Mexican family medicine clinics.” Journal of hypertension (2013). Svetlana Doubova, Héctor Lamadrid-Figueroa, Ricardo Pérez-Cuevas.

Working group 3: Improvement

Working group 3 will review evidence on structural approaches for quality improvement, and develop typology of local contexts matched to potential quality improvement solutions. How do current quality improvement efforts fare?

• “Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa” Health Affairs (2016). Hannah H. Leslie, Anna Gage, Humphreys Nsona, Lisa R. Hirschhorn, and Margaret E. Kruk

There is still a long way to go for improving quality. Why we need to look beyond utilization to quality improvement:

• Beyond utilization: measuring effective coverage of obstetric care along the quality cascade; Elysia Larson, Daniel Vail, Godfrey M Mburuku, Redempta Mbatia, and Margaret E. Kruk

Working group 4: Ethics and equity

Working group 4 will explore the right to good quality care in the era of universal health coverage, and describe the equity of quality care. What does the current equity distribution of quality care look like?

• Poor Quality for Poor Women? Inequities in the Quality of Antenatal and Delivery Care in Kenya; Jigyasa Sharma, Hannah H. Leslie, Francis Kundu, Margaret E. Kruk