The World Health Organization (WHO) has released a new report: ‘Delivering Quality Health Services – a Global Imperative for Universal Health Coverage’.
The document describes the essential role of quality in the delivery of health care
services. There is a growing acknowledgement that optimal health care cannot be delivered by simply ensuring coexistence of infrastructure, medical supplies and health care providers.
Improvement in health care delivery requires a deliberate focus on quality of health services, which involves providing effective, safe, people-centred care that is timely, equitable, integrated and efficient.
Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
Data show that quality of care in most countries, particularly low- and middle-income
countries, is suboptimal.
High-quality health services involve the right care, at the right time, responding
to the service users’ needs and preferences, while minimizing harm and resource
Quality health care increases the likelihood of desired health outcomes and
is consistent with seven measurable characteristics:
- people centredness,
- integration of care and
To ensure that quality is built into the foundations of systems, governments, policy-makers, health system leaders, patients and clinicians should work together to:
- ensure a high-quality health workforce;
- ensure excellence across all health care facilities;
- ensure safe and effective use of medicines, devices and other technologies;
- ensure effective use of health information systems;
- develop financing mechanisms that support continuous quality improvement.
When trying to improve the quality of the health care system, seven categories of interventions stand out and are routinely considered by health system stakeholders, including providers, managers and policy-makers:
- changing clinical practice at the front line;
- setting standards;
- engaging and empowering patients, families and communities;
- information and education for health care workers, managers and policy-makers;
- use of continuous quality improvement programmes and methods;
- establishing performance-based incentives (financial and non-financial);
- legislation and regulation.
All governments should:
- have a national quality policy and strategy;
- demonstrate accountability for delivering a safe high-quality service;
- ensure that reforms driven by the goal of universal health coverage build quality
into the foundation of their care systems;
- ensure that health systems have an infrastructure of information and information
technology capable of measuring and reporting the quality of care;
- close the gap between actual and achievable performance in quality;
- strengthen the partnerships between health providers and health users that drive
quality in care;
- establish and sustain a health professional workforce with the capacity and
capability to meet the demands and needs of the population for high-quality care;
- purchase, fund and commission based on the principle of value;
- finance quality improvement research.
All health systems should:
- implement evidence-based interventions that demonstrate improvement;
- benchmark against similar systems that are delivering best performance;
- ensure that all people with chronic disease are enabled to minimize its impact on
the quality of their lives;
- promote the culture systems and practices that will reduce harm to patients;
- build resilience to enable prevention, detection and response to health security
threats through focused attention on quality;
- put in place the infrastructure for learning;
- provide technical assistance and knowledge management for improvement.
All citizens and patients should:
- be empowered to actively engage in care to optimize their health status;
- play a leading role in the design of new models of care to meet the needs of the
- be informed that it is their right to have access to care that meets achievable
modern standards of quality;
- receive support, information and skills to manage their own long-term conditions.
All health care workers should:
- participate in quality measurement and improvement with their patients;
- embrace a practice philosophy of teamwork;
- see patients as partners in the delivery of care;
- commit themselves to providing and using data to demonstrate the effectiveness
and safety of the care.
Link to the WHO news release:
Link to the Report:
Link to commentary in the BMJ: