Quality Evidence for Health System Transformation (QuEST) Network

Evidence shows that 60% of all avoidable deaths (about 5 million people/year) in low and middle-income countries occur among people who actually accessed care. The response to the Covid-19 has revealed major gaps with regard to health systems’ capacity to adapt to shocks and provide quality care efficiently. Hence quality health systems that “optimize health care by consistently delivering care that improve or maintain health outcomes, by being valued and trusted by all people, and by responding to changing population needs” need to be built. Since its 2019 direct participation in the elaboration of Bellagio Declaration on High-Quality Health System[1], SDC promotes cost-effective investments and innovative research to improve quality of healthcare structural arrangements and delivery models. Yet, research and programming aiming at addressing quality have overwhelmingly focused on the service provision level, while the insufficient performance is largely attributable to complex structural, system-wide failures. In partnership with Harvard University, regional research networks and Swiss academia, SDC will support the creation of a global multi-stakeholder movement (the QuEST movement) that develops, tests and implements open-source products such as more manageable quality measurement tools and innovative evaluations of large-scale system improvement approaches.

[1] The Bellagio Declaration on High-Quality Health systems is a resolution adopted by 19 Institutions and governments in Bellagio (Italy) in June 2018.  As a result of the recommendations of the Lancet Commission on High-Quality Health Systems (see foot note 2). SDC was part of the advisory panel of such Commission and one of the first signatories to the declaration.

Direct beneficiaries are:

- research institutes and health systems researchers in low and middle-income countries who will develop their skills and capacities in quality assessment and improvement methodologies

- governments that will benefit from relevant evidence on system quality to inform their policies.

Ultimately these investments as well as the continuous application of efficient and affordable assessment tools and innovation evaluations of large-scale health system improvements will benefit patients in low and middle-income countries through adopted health policies privileging higher quality of care according to population’s needs.

1. To build high quality evidence base and catalyze policy change for health system transformation in selected low and middle-income countries

2 To establish a global movement and research agenda related to quality of health systems

Risultati principali attesi:  

The following key outputs will be achieved
in Phase I:
1.  The QuEST Network’s Core Group is
established with an operational platform
built at Harvard University managing a core
group of 4 low- and middle-income country-based
QuEST Centers.

2. The main steering bodies of the Core
Group are created and operationalized

3. A larger QuEST movement involving
other relevant stakeholders is set up and
operationalized

4. Research communication and
dissemination tools are created.

5. Evidence is generated around three
methodological streams to achieve and
validate improvements in the quality of
health systems.

Risultati fasi precedenti:  

The inception phase (CHF 149’000) mainly achieved results linked with the project’s setup and identification of the research streams:

1)   Governance arrangements and overall structure of the QuEST movement were defined

2)   Initial model of health systems’ redesign was tested in Tanzania

3)   Proof of concept for the use of technology to measure end users’ satisfaction was validated

4)   Partner countries and regions for setting up first QuEST centers were identified (Ethiopia, Kenya, India, South Africa, Latin America consortium in Argentina, South-East Asia consortium in China)