DISTRICT LEVEL

The health district is an essential element of a national health system. This level is the key interface between health facilities and higher levels, and is responsible for operationalizing national strategic direction on quality. It is at this level that planning, implementation, monitoring and supervision of activities to improve quality of health services in facilities and communities are carried out (e.g. states, regions, provinces or counties). In these cases, the guidance for the district level needs to be adapted according to their roles in health planning and implementation

There are various activities that staff at the district level (particularly district health leadership and teams) can support and implement to improve quality of health services. Work at the district level should be coordinated with national and facility-level authorities to ensure coherence and strengthening in the delivery of quality health services designed to meet the needs of people..

Summary of actions:

• Align district commitment to national quality goals and priorities
• Develop district quality structures and operational plan, and where they already exist, update district quality operational plans based on learning from health facilities and emerging national strategic direction on quality
• Orient health facilities to district- and national-level quality goals and priorities
• Respond to facility needs in reaching selected aims and ensure functioning support systems for quality health services
• Maintain engagement with the national level on quality health services
• Adapt quality interventions to district-level contexts

To support implementation of key activities at the national-level, you are encouraged to review the WHO Quality Toolkit