Quality of care measurement in maternal, newborn, child, and adolescent health and ageing
Introduction
Globally, there is growing recognition of the role of quality health services in reducing preventable morbidity and mortality and in improving client experience with the care they receive. The Lancet Commission report on High-Quality Health Systems in the Sustainable Development Goals provides empirical evidence in support of the view that “providing health services without guaranteeing a minimum level of quality is ineffective, wasteful, and unethical”. Generating and using good quality data to measure the quality of both clinical and perceived care are often, and should be, essential characteristics of health systems that strive to provide good quality services. In maternal, newborn, child, and adolescent health and ageing (MNCAHA), quality of care measurement can provide critical insights to guide quality planning, quality improvement, quality assurance, quality control, as well as regulation and accreditation.
What we do
Quality of care measurement is a cross-cutting function within the Department of Maternal, Newborn, Child and Adolescent Health and Ageing (MCA). The purpose of this function is to improve the coordination of the quality-of-care measurement activities across life stages in the department by developing and promoting the use of a harmonized methodology, frameworks, technical guidance, and tools for quality-of-care measurement; and supporting their implementation at global, national, subnational, and health facility level.
Within the context of quality-of-care measurement in MCA, "life stages" refer to the following distinct periods of life, each with unique health needs and priorities:
- Maternal health: Care focused on women during pregnancy, childbirth, and the postpartum period, addressing maternal well-being and safe delivery practices.
- Newborn health: Care from birth to 28 days, a critical period for survival, growth, and development, with interventions to prevent mortality and morbidity.
- Child health: Encompasses the health of children from 1 month to 9 years, including preventive and curative services aimed at reducing common childhood illnesses and promoting development.
- Adolescent health: Care for individuals between 10 and 19 years, addressing physical, mental, and social health needs, including reproductive health, mental health, and injury prevention.
- Ageing Health: Care for individuals aged 60 or 65 and above, with an emphasis on managing age-related conditions, promoting healthy ageing, and maintaining quality of life.
Each of these stages requires tailored quality-of-care measures to address specific health risks, interventions, and outcomes.
The life stages quality of care metrics technical working group
The life stages quality of care metrics technical working group (LSQM TWG) was established by MCA in 2021 to support its agenda on the development of a harmonized methodology, framework, guidance, and tools for quality-of-care measurement across life stages. The TWG is co-convened by WHO and UNICEF as the secretariat and its membership consists of three groups whose roles are explained below.
- Members from the WHO’s MNCAHA measurement Technical Advisory Groups (TAGs): Each measurement TAG—MoNITOR, CHAT, GAMA, and TAG4MA —has appointed two members with expertise in quality-of-care measurement to represent their group across the various workstreams established by the TWG
- Members from other relevant WHO departments: Given the cross-cutting role of the TWG, technical focal points from other relevant WHO departments and units are included in the TWG to provide complementary and specialized expertise.
- External pool of independent experts, experts from partners institutions, and observers: This pool of experts in quality-of-care measurement plays a vital role in ensuring that recommendations are context-sensitive across countries and grounded in the latest evidence. To align closely with other global quality-of-care measurement initiatives, representatives from technical and implementing partners who lead or contribute to this field are invited to join specific technical discussions as needed. These partners provide valuable technical support across various workstreams, and donor agency representatives with an interest in these discussions or workstreams are also actively engaged.
The membership of the TWG fluctuates over time to adapt to evolving priorities. As new areas of focus emerge or previous priorities are phased out, the group composition adjusts to ensure the presence of relevant expertise. This flexible structure allows the TWG to remain responsive, drawing on the necessary technical knowledge to address current needs effectively.
LSQM TWG members (As of November 2024)
Secretariat
Technical Officer (MNCAH Quality of Care Measurement), Department of Maternal, Newborn, Child, Adolescent Health, and Ageing, World Health Organization, Geneva, Switzerland
Planning Specialist, Maternal Newborn Health, UNICEF, New York, United States of America
Co-chairs
Maternal and Child Survival Programme Maternal and Child Survival Program USAID Grantee JHPIEGO Washington, DC, United States of America
Takeda Chair in Global Child Health and Deputy Director of the MARCH Centre, London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom of Great Britain and Northern Ireland
TWG members
Post-doctoral researcher, Department of Paediatrics and Child Health, School of Medicine University of Nairobi, Kenya
Kalaeb Baye
Associate Professor, Director of the Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
Christine Bohne
Quality Improvement and Data for Action Director with NEST360 & Rice University, United States of America
Emily Carter
Associate, International Health, Global Disease Epidemiology and Control, United States of America
UN Major Group for Children and Youth, United Kingdom of Great Britain and Northern Ireland
Lisa Ruth Hirschhorn
Professor of Medical Social Science at Northwestern University Feinberg Medical School and a Senior Lecturer at UGHE; United States of America
University of Yamanashi, Japan
Shogo Kubota
Coordinator, Maternal Child Health and Quality Safety; World Health Organization Philippines
Director, WHO Collaborating Centre for Maternal and Child Health; Professor of Global Child Health, London School of Hygiene and Tropical Health, United Kingdom of Great Britain and Northern Ireland
Claire Hellene Mershon
Senior advisor, Global Health Visions, New York, United States of America
Jean-Pierre Monet
Technical Officer, Department of Maternal, Newborn, Child, Adolescent Health, and Ageing; World Health Organization, Geneva, Switzerland
Sara Riese
Senior Demographic and Health Researcher, The Demographic and Health Survey (DHS) Program And ICF; United States of America
Gulnara Semenov
Senior Survey Coordinator & Health Advisor. DHS programme, United States of America
Lead epidemiologist, Centers for Disease Control and Prevention (CDC), Division of Reproductive Health; United States of America
Scientist, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
Independent Consultant and Public Health Specialist, United States of America
Sara Wuehler
Senior Technical Advisor, Nutrition International (& UNICEF/WHO TEAM), Ottawa, Canada
Medical Officer, Department of Maternal, Newborn, Child, Adolescent Health, and Ageing; World Health Organization, Geneva, Switzerland
Associate Professor, University of California, San Francisco (UCSF); Departments of Obstetrics, Gynecology, & Reproductive Sciences and Epidemiology & Biostatistics, San Francisco, United States of America
Maternal, Neonatal, Child, Adolescent Health Data Lead, UNICEF, New York, United States of America
Manager of the Population Estimates Program, Demographer and Statistician & International Consultant in civil registration and vital statistics, Portland State University, United States of America
Technical Director, JSI Research and Training Institute, Inc., Boston, United States of America and Georgia
London School of Hygiene and Tropical Medicine, United Kingdom of Great Britain and Northern Ireland
Senior Technical Advisor Monitoring, Evaluation and Learning and Child Health at JSI, Maryland, United States of America
Associate Professor, Karolinska Institute, Sweden
Team Lead for Newborn Health for MCSP, Save The Children, United States of America
Epidemiologist and Assistant Professor, University of California, San Francisco, United Stats of America
Scientist, Department of International Health at Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States of America.
Professor of Implementation Science, London School of Hygiene & Tropical Medicine, United Kingdom of Great Britain and Northern Ireland
Consultant, Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO
Senior Health Specialist, Mother and Newborn, Technical Manager, Global Financing Mechanism, GFF, Washington DC, United States of America
Assistant Professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
Lorine Pelly
Child Health and Pediatric Infectious Diseases, Institute for Global Public Health, University of Manitoba, Canada
University of Melbourne, Australia
Senior Implementation Research Advisor, Bureau for Global Health, USAID, United States of America
Senior Data Scientist Rapid-cycle monitoring (FASTR), Global Financing Facility Secretariat, United States of America
Senior Program Director International Programs, Population Reference Bureau, United States of America