Washington D.C, 3 October 2019 (PAHO/WHO) – Ministers of health from throughout the Americas have endorsed a series of actions to ensure that all people have equitable access to timely, efficient, safe, and quality health services that address health needs.
The Strategy and Plan of Action to Improve Quality of Care in Health Service Delivery 2020-2025, adopted by the 57th Directing Council of the Pan American Health Organization (PAHO), sets out a people- and community-centered approach that focuses on overcoming persisting barriers to equitable access to quality care.
While countries of the Region have made progress to improve quality of care in health service delivery, mortality attributable to quality issues remains high.
Health systems in the Region of the Americas are characterized by high levels of segmentation and fragmentation that hinders access to quality health care services, compromises health outcomes, and results in the inefficient use of available resources.
“While countries of the Region have made progress to improve quality of care in health service delivery, mortality attributable to quality issues remains high,” said PAHO Director Carissa F. Etienne. “This strategy represents a paradigm shift in how countries should approach health care and a move towards care that puts the experience of people and their communities first,” she said.
In 2007, PAHO Member States adopted the Regional Policy and Strategy for Ensuring Quality of Health Care. Since then, actions have been implemented to improve quality, including through the development of policies and quality standards, the establishment of national directorates responsible for quality, and standards for health facility licensing.
Despite these initiatives, however, population surveys in some countries show that 30% of people still lack access to preventive care and treatment, and of those who do receive such services, just 39% consider the quality of care to be good.
When it comes to patient safety, deaths resulting from poor-quality care remain high, ranging from 47 to 350 deaths per 100,000 people in 2014. Data show that in some countries, up to 40% of hospitalizations may be preventable because they involve health problems that could be addressed in outpatient facilities, indicating deficiencies in the quality and effectiveness of the first level of care.
Furthermore, the average public expenditure on health in the Region stands at just 4.2% of gross domestic product (GDP), far below the 6% proposed as a benchmark to improve equity and efficiency. This has both a direct and indirect impact on the quality of services provided.
To tackle these issues and ensure the delivery of comprehensive health services based on national contexts, needs, vulnerabilities and priorities, the Plan proposes three strategic lines of action:
- Implement continuous processes to improve the quality of care to people, families, and communities in the delivery of comprehensive health services
- Strengthen the stewardship and governance of health systems to develop a culture of quality
- Establish financing strategies that promote improvement in quality of care in the delivery of comprehensive health services.
“This strategy and plan of action represents an important paradigm shift in how we see equity in health care delivery in the Region,” said James Fitzgerald, Director of Health Systems and Services at PAHO. “A systems approach to this issue will not only improve the experience of individuals but will also address the permanent barriers to access that remain throughout the Region.”
