gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Using clinical guidelines to improve the quality of care in countries moving towards Universal Health Coverage: Initial evidence from 10 countries

Meeting Abstract

  • D. Cutler - National Institute for Health and Clinical Excellence, London, UK
  • F. Cluzeau - National Institute for Health and Clinical Excellence, London, UK
  • P. Barker - Institute for Healthcare Improvement, Cambridge, MA, USA
  • K. Chalkidou - National Institute for Health and Clinical Excellence, London, UK
  • K. Mate - Institute for Healthcare Improvement, Cambridge, MA, USA
  • T. Morente - Institute for Healthcare Improvement, Cambridge, MA, USA
  • Z. Sifrim - Institute for Healthcare Improvement, Cambridge, MA, USA
  • H. Smits - Institute for Healthcare Improvement, Cambridge, MA, USA

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP129

DOI: 10.3205/12gin241, URN: urn:nbn:de:0183-12gin2416

Veröffentlicht: 10. Juli 2012

© 2012 Cutler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Many low to middle income countries (LMICs) are currently pursuing reforms for achieving universal health coverage (UHC) at an affordable cost. These reforms present a unique opportunity to build in quality strategies, including use of evidence-informed clinical guidelines, at an early stage of design. Literature suggests that LMICs are using guidelines in their reform efforts; however, details of how guidelines are developed and used are unknown.

Objectives: The Joint Learning Network for Universal Health Coverage (JLN) is a consortium of LMICs pursuing universal access through a shared learning platform. As part of the JLN's ‘Quality Track’ we sought to examine the extent to which LMICs use clinical guidelines to improve healthcare quality in their UHC reforms, including practical and political barriers to their development and use.

Methods: Semi-structured interviews were conducted over three months with guideline developers, policy makers and clinicians in 10 LMIC members of the JLN.

Results: All countries make some use of guidelines as a quality improvement tool in their reform efforts. Methods of development vary considerably. Technical and political challenges to guideline production and use emerged, including problems identifying good quality evidence relevant to the local setting, and ensuring that guideline recommendations are optimally implemented.

Discussion/Implications for guideline developers/users: Evidence-informed guidelines, when suitably linked with decision-making processes and backed by support and incentives for uptake can be a powerful lever for improving quality in LMICs moving to Universal Health Care. Local technical and political barriers often inhibit development and use of such guidance.