Institutional Roles and Relationships Governing the Quality of Health Care: Country Experiences, Challenges, and Lessons Learned

The document is a collaborative effort between the USAID Health Finance and Governance Project and the USAID Applying Science to Strengthen and Improve Systems Project. The publication highlights the significance of governance in ensuring the quality of health services, citing the need for effective leadership, management, and coordination among various stakeholders. It emphasizes the importance of defining quality health services and improving quality in a health system through various strategies, policies, and mechanisms. The authors conducted a literature review, semi-structured interviews, and peer consultation to gather insights on the topic. The findings suggest that good health system governance is essential for delivering quality health services, and that it involves structural and process stones, including governing quality with strategies, policies, and other mechanisms, using regulatory techniques, institutionalizing non-state involvement, and garnering political will. The publication identifies eight stones for governing quality, which are categorized into structural and process stones. The structural stones include governing quality with strategies, policies, and other mechanisms, using regulatory techniques, and institutionalizing non-state involvement. The process stones include measuring and using data for quality improvement, developing a quality improvement culture, addressing the knowledge gap of quality care, and linking finance to quality. The authors also highlight the importance of measuring and using data for quality improvement, developing a quality improvement culture, and addressing the knowledge gap of quality care at various levels. They emphasize the need for a quality improvement culture that is embedded in the health system, and for addressing the knowledge gap of quality care through training, education, and research. The publication concludes by emphasizing the importance of good health system governance in delivering quality health services, and the need for continued efforts to improve quality in a health system. It highlights the challenges and lessons learned from country experiences, and provides recommendations for policymakers, practitioners, and researchers. The authors of the publication include experts from various organizations, including Abt Associates, University Research Co., LLC, World Health Organization, Institute for Healthcare Improvement, and others. The publication is a valuable resource for policymakers, practitioners, and researchers interested in improving the quality of health services in developing countries. The publication is a result of a collaborative effort between the USAID Health Finance and Governance Project and the USAID Applying Science to Strengthen and Improve Systems Project. The project aimed to improve health and social services in USAID-assisted countries, strengthen their health systems, and advance the frontier of improvement science. The publication is a comprehensive resource that provides insights on the principles of good health system governance, its importance in delivering quality health services, and the challenges and lessons learned from country experiences. It highlights the need for continued efforts to improve quality in a health system, and provides recommendations for policymakers, practitioners, and researchers.