Keep the conversation going on quality and UHC: A reflection for UHC Day 2016

Lani Marquez

Knowledge Management Director, USAID ASSIST Project/URC

The Global Symposium on Health Systems Research held last month in Vancouver afforded a rich opportunity to focus the thinking of donors, academics, implementers, and governments on what we know and what we still need to learn about strengthening health systems in pursuit of Universal Health Coverage.  

The drum those of us in the improvement camp beat at the Symposium was to make sure that quality stays prominent on the UHC agenda by drawing attention to the many ways that quality improvement furthers effective coverage and as well other goals associated with UHC, like equity, people-centeredness, and efficiency.  A key event for us at the Symposium was a session supported by USAID through ASSIST, where our colleagues from the WHO Service Delivery and Safety Department launched their new Global Learning Laboratory for Quality Universal Health Coverage (QUHC).  

The Global Learning Lab or GLL will use a platform on the WHO-sponsored Integrated Care 4 People website to connect those who participate to share knowledge and experiences, challenge ideas, and spark new thinking and innovation.  The GLL is open to anyone who wants to engage with others to analyze and reflect on approaches to promote quality UHC.

In the spirit of an open exchange of ideas among peers, the launch event used a knowledge café to bring policymakers, implementers, and researchers together to debate promising implementation experiences to advance quality in UHC.  Based on issues that the Quality UHC team at WHO is already working on with various stakeholders, we discussed four big topic areas: Quality Policy and Strategy: Quality Interventions; Monitoring and Research on Quality UHC; and Quality, Health System Resilience, and Global Health Security.

Quality UHC knowledge café at Health Systems Global 2016. Photo credit: Nancy Dixon

What did we learn?

The Policy and Strategy conversations raised excellent themes that WHO colleagues want to build on through the GLL.  First, a recognition that perspectives on what constitutes quality differ widely among participants in the health system but that we should focus on quality aspects that are tied to outcomes.  Second, appreciation for the important role of communities in demand and advocacy for quality.  And third, the urgency of embedding quality in national health policy, financing mechanisms, and governance.

The Quality Interventions discussions recognized the importance of addressing quality through both the supply and demand sides, ranging from consumer unions, instilling professional values through pre-service training and professional codes of conduct, mentoring, structural interventions to incentivize not only adherence to evidence-based guidelines but also patient-centered care, to attention to the “basics” of water and sanitation.

The Monitoring and Research group weighed issues of the wide variety of quality of care indicators that countries are using, recognizing that these often must be context-specific; the need for incorporating quality in accountability mechanisms; and the critical task of engendering stronger ownership and use of quality data, especially at the service delivery level.

The System Resilience and Health Security table focused on how quality improvement interventions make health systems more resilient, by strengthening subnational decision-making about how to improve care quality, empowering frontline health workers to prioritize and respond to gaps in quality, and building the foundation of trust in the health care system at the community and facility levels.

The value of a conversation space like the GLL was evident in the knowledge that participants brought to the table, particularly with respect to strategies and interventions that are working.  They also voiced interest in other areas they would like to see addressed by the GLL, including making quality a social movement, social protection and quality of care in UHC, leveraging mHealth/eHealth to monitor the quality of UHC, health workforce and QUHC, and financing quality, among others.

People in the room seemed keen to talk with peers about these issues, especially those from different countries and perspectives.  The new WHO Global Learning Lab for Quality UHC offers a platform to convene more dialogue and learning among peers.  We hope you’ll join the conversation.

To learn more about the Global Learning Lab for QUHC, contact


Thanks for this, Lani! Definitely offers some good food for thought as we move towards improving UHC

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