Health system quality in the time of COVID-19

Type Journal Article Author Sanam Roder-DeWan URL https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(20)30223-0.pdf Series The Lancet Global Health Comment Volume 8 Publication The Lancet Global Health / Health Section, UNICEF Tanzania Country Office Date 06/05/2020 DOI https://doi.org/10.1016/S2214-109X(20)30223-0 Abstract As low-income countries in sub-Saharan Africa respond to coronavirus disease 2019 (COVID-19), underlying health system quality must be carefully considered and included in the design and delivery of services. What works in high-income settings might not translate to low-income countries if the quality of health care at baseline is poor and, although steady and impressive progress on quality has been made in some low-income countries,1concerning gaps remain. Studies show that providers in these contexts often perform less than half of the most basic elements of a high-quality visit; equipment and supplies continue to be a challenge; and clinical outcomes directly amenable to high-quality care, such as early neonatal mortality, continue to be poor.2,3 In The Lancet Global Health, Timothy Powell-Jackson and colleagues4make an important contribution to this growing literature on the quality of care and, unfortunately, document similarly troubling shortcomings, this time for provider infection prevention and control behaviours. As COVID-19 cases rise in sub-Saharan Africa, Powell-Jackson and colleagues’ analysis is a clarion call to urgently attend to the basic quality of services provided in the health system