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Disease Control Priorities in Developing Countries. 2nd edition.
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Chapter 70Improving the Quality of Care in Developing Countries
John W. Peabody, Mario M. Taguiwalo, David A. Robalino, and Julio Frenk.
Although the quantity rather than quality of health services has been the focus historically in developing countries, ample evidence suggests that quality of care (or the lack of it) must be at the center of every discussion about better health. The following examples are illustrative: In one study evaluating pediatric care in Papua New Guinea, 69 percent of health center workers reported that they checked for only two of the four examination criteria for pneumonia cases. Only 24 percent of these workers were able to indicate correct treatment for malaria. When clinical encounters were observed at aid posts, providers met minimal examination criteria in only 1 percent of cases (Beracochea and others 1995). In a study in Pakistan, only 56 percent of providers met an acceptable diagnostic standard for viral diarrhea, and only 35 percent met the acceptable standard for treatment (Thaver and others 1998).
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Quality Definition and Population Framework
These deficiencies in quality of care represent neither the failure of professional compassion nor necessarily a lack of resources (Institute of Medicine 2001). Rather, they result from gaps in knowledge, inappropriate applications of available technology (Murray and Frenk 2000), or the inability of organizations to change (Berwick 1989). Local health care systems may have failed to align practitioner incentives and objectives, to measure clinical practice, or to link quality improvement to better health outcomes.
Skip to main content
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Bottom of Form
Disease Control Priorities in Developing Countries. 2nd edition.
Show details
Contents
Top of Form
Search term
Bottom of Form
< PrevNext >
Chapter 70Improving the Quality of Care in Developing Countries
John W. Peabody, Mario M. Taguiwalo, David A. Robalino, and Julio Frenk.
Although the quantity rather than quality of health services has been the focus historically in developing countries, ample evidence suggests that quality of care (or the lack of it) must be at the center of every discussion about better health. The following examples are illustrative: In one study evaluating pediatric care in Papua New Guinea, 69 percent of health center workers reported that they checked for only two of the four examination criteria for pneumonia cases. Only 24 percent of these workers were able to indicate correct treatment for malaria. When clinical encounters were observed at aid posts, providers met minimal examination criteria in only 1 percent of cases (Beracochea and others 1995). In a study in Pakistan, only 56 percent of providers met an acceptable diagnostic standard for viral diarrhea, and only 35 percent met the acceptable standard for treatment (Thaver and others 1998).
Go to:
Quality Definition and Population Framework
These deficiencies in quality of care represent neither the failure of professional compassion nor necessarily a lack of resources (Institute of Medicine 2001). Rather, they result from gaps in knowledge, inappropriate applications of available technology (Murray and Frenk 2000), or the inability of organizations to change (Berwick 1989). Local health care systems may have failed to align practitioner incentives and objectives, to measure clinical practice, or to link quality improvement to better health outcomes.
References: Case management quality assessment in rural areas of Papua New Guinea.[Trop Doct. 1995] The clinical diagnosis and treatment of important childhood diseases in rural Papua New Guinea.[P N G Med J Quality of health services in Papua New Guinea: what do we know?[P N G Med J. 1993] Review Assessing the quality of healthcare provided to children.[Health Serv Res Review [Current status of the female condom in Africa].[Sante. 1997] See reviews...See all...