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Journal article : Review

Quality of inpatient paediatric and newborn care in district hospitals: WHO indicators, measurement, and improvement

Abstract:
Poor-quality paediatric and neonatal care in district hospitals in low-income and middle-income countries (LMICs) was first highlighted more than 20 years ago. WHO recently developed more than 1000 paediatric and neonatal quality indicators for hospitals. Prioritising these indicators should account for the challenges in producing reliable process and outcome data in these settings, and their measurement should not unduly narrow the focus of global and national actors to reports of measured indicators. A three-tier, long-term strategy for the improvement of paedicatric and neonatal care in LMIC district hospitals is needed, comprising quality measurement, governance, and front-line support. Measurement should be better supported by integrating data from routine information systems to reduce the future cost of surveys. Governance and quality management processes need to address system-wide issues and develop supportive institutional norms and organisational culture. This strategy requires governments, regulators, professions, training institutions, and others to engage beyond the initial consultation on indicator selection, and to tackle the pervasive constraints that undermine the quality of district hospital care. Institutional development must be combined with direct support to hospitals. Too often the focus of indicator measurement as an improvement strategy is on reporting up to regional or national managers, but not on providing support down to hospitals to attain quality care.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1016/s2214-109x(23)00190-0

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-7427-0826
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author


Publisher:
Elsevier
Journal:
Lancet Global Health More from this journal
Volume:
11
Issue:
7
Pages:
E1114-E1119
Publication date:
2023-05-23
Acceptance date:
2023-04-03
DOI:
EISSN:
2214-109X
Pmid:
37236212


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1346829
Local pid:
pubs:1346829
Deposit date:
2023-06-21

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