What is Quality? Quality of Care Frameworks
In this chapter, we present a review of existing frameworks and a comprehensive framework for improving quality of care in family planning. We discuss the two most popularly used frameworks for defining quality of care: Donabedian’s framework in health (Donabedian, 1988), and the Bruce-Jain framework in family planning. Then we briefly describe the National Quality Assurance Programme of the Ministry of Health and Family Welfare (MoHFW), Government of India, implemented by the National Health Systems Resource Centre (NHSRC). We discuss how the Bruce-Jain quality of care framework relates to rights-based programmes. We conclude the chapter with a discussion of what we can learn regarding quality of care in family planning from quality of care improvement in the health sector. Finally, more recent literature discusses the importance of health system functioning and community norms in a programme’s ability to provide quality of care, in essence providing an ecosystem for quality of care improvement interventions to achieve their full potential. Building on this literature, we present a comprehensive framework for improving quality of care.
KeywordsQuality of care frameworks Quality assurance Ecosystem Health system
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