Meeting the MDGs, sensibly, started with improving access to care. While universal health care has certainly not been attained in all LMICs, better access and utilization have revealed striking gaps in the quality of health care that is provided. This raises the very worrisome practicality that “access to poor quality of health services may be no better than no access at all.” Raising the quality of health care, however, is arguably even more challenging than increasing access or other structural elements of care, such as drugs, equipment, and facilities.
Research and policy in the past decade have revealed the depth of this problem and illuminated some possible solutions. Quality of care criteria, for example, is increasingly available from the evidence-based literature. Measurement against those criteria, at a systemic level, is gradually being expected. And there have even been national level efforts to implement quality improvement through policies and national roll-outs.
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