WHO today launched a new guide on Measuring and monitoring quality of care for maternal, newborn, child, and adolescent health services . The guide and its accompanying tool are designed to support programme managers, policymakers and health workers in strengthening efforts to measure, monitor and improve the quality of health services, especially for maternal, newborn, child and adolescent health.
Key messages in the guide include the following.
To monitor quality improvement initiatives, it is important to select quality of care (QoC) indicators that are closely aligned with the improvement aims. These indicators should reflect the targeted care outcomes, key processes, essential inputs to be improved, and any potential unintended consequences. While there's no one-size-fits-all approach, a range of helpful resources is provided to guide the process.
To effectively monitor and improve quality of care, it's important to assess and strengthen the health information system (HIS) to ensure it can capture relevant indicators. Some needed QoC indicators may not exist in the local HIS, and evaluating its readiness can highlight gaps and integration opportunities. However, adding new indicators should be carefully planned, aligned with programme priorities, and based on available resources and national HIS review cycles. Ideally, only indicators essential for long-term monitoring should be integrated, as including those for short-term initiatives may overburden the system.
Regular measurement of selected quality indicators is essential for tracking progress and guiding improvements. In addition to monitoring whether QoC indicator results are improving as they make changes, quality improvement teams can use qualitative information to assess whether the specific changes they are testing are feasible, acceptable, and sustainable in the local setting. Both quantitative and qualitative information is important for improvement and learning.
High-quality data is crucial for accurate insights and building trust amongst quality improvement actors. There is a cycle of data use and quality, which can either strengthen or erode both elements: when the quality of data is poor it is less trusted and less used, leading to lower demand for data and less resources invested into strengthening data systems. Interventions to assess and improve the quality of data can be applied to data already available HIS or to data that is collected during a time-limited quality improvement initiative.
When managers and health workers lack experience with selecting, measuring or interpreting QoC indicators, practical support is essential to build their skills. This can include education, training, mentoring and professional development tailored to their roles. Scaling up these competencies also requires supportive policies, strong leadership, technical resources, sustainable funding, skilled staff and coordination between the health and education sectors.
With the right tools, clear indicators and empowered health workers, measuring quality of care becomes more than a task; it becomes a driver for better health for every mother, newborn, child and adolescent.
