What should I consider?

It is important for Toolkit users to have at least an elementary understanding of quality through a health systems approach–how tasks, interventions and actions impact the health system–when using the tools contained in the Toolkit. The WHO health systems building blocks are a frequently cited approach to understanding health systems. The more recent Operational framework for primary health care: transforming vision into action provides a clear entry point for action to improve quality of health services using a primary health care approach. These broad frameworks are useful for envisaging how health systems might respond to specific quality-focused approaches. Engagement mechanisms are critical at all levels of the system to ensure adequate representation and to support a joint vision on quality.

The tools curated as part of this Toolkit typically require adaptation and contextualization to local contexts and needs. You should carefully consider such modifications before using tools to execute or support specific actions.

The Toolkit recognizes five foundational requirements across the health system, which culminate in a health system-wide approach. Onsite support is required to ensure health workers receive the necessary coaching, mentoring and clinical skills support to improve quality. Measurement mechanisms are required to track the delivery of quality health services and promote accountability. Sharing and learning are required to enable exchange of experiences in improving quality between and across health system levels. Stakeholder and community engagement are required to ensure regular, active, and meaningful engagement of the community in quality improvement efforts. And finally, management is required to ensure activities to improve quality are carried out within a functional support architecture.

Authorities at the national, district and facility levels of the health system are encouraged to adopt and adapt approaches that are most appropriate for their context.