Quality improvement in health care in developing countries

• 1. Quality Improvement In Health Care In Developing CountriesPRESENTED BY ROLL NO PURNIMA TIMILSINA16RAJESH KUMAR YADAV19 SAGUN PAUDEL22

2. IntroductionDefinition of Quality: Quality is a degree of excellence. In health care, quality is defined in the light of the providers technical standards and patients 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 3. Quality of health care should always fulfill threepoints which are; It should fulfill clients or patients need and wants. It should give positive impact on health status. It should follow scientifically approved methods andtechniques.Quality of care is views in 3 perspective; Client/community perspective Service providers perspective Manager/supervisors perspective. 4. Client perspective:Quality of care includes effectiveness, Accessibility, Interpersonal relation, continuity and amenities. Service providers perspective:It implies the skills, resources and other conditions necessary to improve health status. Health care manager/ supervisors perspective:Involves addressing needs of clients/ service providers through resource allocation, mobilization etc. 5. Objective:General Objectives: To Study Quality Improvement in Health Care inDeveloping 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 improvequality To study how to Measurement of quality Analyze the Economic benefits and costs ofquality 6. Cont.. Poor quality mental health services can violate basichuman rights, lead to negative therapeutic outcomesand prevent people from enjoying the highest standardof physical and mental health. However, poor quality of care can be substantiallyredressed through concerted and systematic qualityimprovement strategies. While prescribing methods for improving the quality ofmental health services is challenging, not least becausethere is tremendous variation in the availability offinancial and human resources in different countries,providing guidance to countries to assist them to attain 7. Inadequate resources are a major reason for poorquality mental health care, especially in low- andmiddle-income countries . This needs to be rectified through additionalallocation of resources, advocacy, training andother mechanisms. 8. The degree to which health services for individualsand populations increase the likelihood of desiredhealth outcomes and are consistent with currentprofessional knowledge (Institute of Medicine, 2001) 9. METHODOLOGYSecondary data 10. Finding and discussion: Elements of Quality:Quality comprises three elements: Structure refers to stable, material characteristics(infrastructure, tools, technology) and theresources of the organizations that provide careand the financing of care (levels of funding,staffing, payment schemes, and incentives). Process is the interaction between caregiversand patients during which structural inputs fromthe health care system are transformed intohealth outcomes. 11. Outcomes:can be measured in terms of health status, deaths, or disability-adjusted life yearsa 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). 12. Quality of health Care FrameworkPoliticalInstitutionalFactorsfactorsDemographic Health Structure Process outcome/socioecono caremic factors access The Quality of CareCulturalSocial FactorsFactors 13. QUALITY OF CARE INDEVELOPING COUNTRIES :In the fifteen years since the Alma Ata Declaration,in which the international community committeditself to providing primary health care (PHC) forall, major efforts have been made in nearly alldeveloping countries to expand PHC services. 14. 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. 15. 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). 16. 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). 17. Quality of care in Nepal:In Nepal, there is lack of well trained, qualified,midlevel health care workers (MLHCW) in ruralareas. The lack of poor performance of providersat these health posts results in inadequatepreventive and curative health services to thepoor and geographically isolated population of allethnic groups.. 18. 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. 19. Economic Benefits Individual: Physical, emotional and mental health Increased productivity (higher capacity to generateincome, other things being equal) Higher quality prenatal and post natal caredecreases mortality and improves subsequentschool performance (labour productivity)(Van der Gag, 2000) 20. Social: Greater capacity to generate wealth Reduces premature death and disability (labourforce and productivity up) Lower costs for providers and health insurers (lowerpublic expenditure and possibly lower premiums) 21. 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 DevelopingCountries, Lori DiPreteBrown,Lynne MillerFranco,NadwaRafeh,TheresaHatzell