Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review

Introduction Improving healthcare quality in low-/middle-income countries (LMICs) is a critical step in the pathway to Universal Health Coverage and health-related sustainable development goals. This study aimed to map the available evidence on the impacts of health system governance interventions o...

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Main Authors: Robin Gauld, Susan Jack, Tim Stokes, Joby George, Timothy Colbourn
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e073669.full
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author Robin Gauld
Susan Jack
Tim Stokes
Joby George
Timothy Colbourn
author_facet Robin Gauld
Susan Jack
Tim Stokes
Joby George
Timothy Colbourn
author_sort Robin Gauld
collection DOAJ
description Introduction Improving healthcare quality in low-/middle-income countries (LMICs) is a critical step in the pathway to Universal Health Coverage and health-related sustainable development goals. This study aimed to map the available evidence on the impacts of health system governance interventions on the quality of healthcare services in LMICs.Methods We conducted a scoping review of the literature. The search strategy used a combination of keywords and phrases relevant to health system governance, quality of healthcare and LMICs. Studies published in English until August 2023, with no start date limitation, were searched on PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, Google Scholar and ProQuest. Additional publications were identified by snowballing. The effects reported by the studies on processes of care and quality impacts were reviewed.Results The findings from 201 primary studies were grouped under (1) leadership, (2) system design, (3) accountability and transparency, (4) financing, (5) private sector partnerships, (6) information and monitoring; (7) participation and engagement and (8) regulation.Conclusions We identified a stronger evidence base linking improved quality of care with health financing, private sector partnerships and community participation and engagement strategies. The evidence related to leadership, system design, information and monitoring, and accountability and transparency is limited.
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spelling doaj-art-2a86915d110f4e95a95c2bfb6d811d1e2025-08-20T03:52:16ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-073669Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping reviewRobin Gauld0Susan Jack1Tim Stokes2Joby George3Timothy Colbourn4Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand3 Offord Centre for Child Studies, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaGeneral Practice & Rural Health, Otago University, Dunedin, New ZealandDepartment of General Practice & Rural Health, University of Otago, Dunedin, New ZealandUCL Institute for Global Health, London, UKIntroduction Improving healthcare quality in low-/middle-income countries (LMICs) is a critical step in the pathway to Universal Health Coverage and health-related sustainable development goals. This study aimed to map the available evidence on the impacts of health system governance interventions on the quality of healthcare services in LMICs.Methods We conducted a scoping review of the literature. The search strategy used a combination of keywords and phrases relevant to health system governance, quality of healthcare and LMICs. Studies published in English until August 2023, with no start date limitation, were searched on PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, Google Scholar and ProQuest. Additional publications were identified by snowballing. The effects reported by the studies on processes of care and quality impacts were reviewed.Results The findings from 201 primary studies were grouped under (1) leadership, (2) system design, (3) accountability and transparency, (4) financing, (5) private sector partnerships, (6) information and monitoring; (7) participation and engagement and (8) regulation.Conclusions We identified a stronger evidence base linking improved quality of care with health financing, private sector partnerships and community participation and engagement strategies. The evidence related to leadership, system design, information and monitoring, and accountability and transparency is limited.https://bmjopen.bmj.com/content/13/12/e073669.full
spellingShingle Robin Gauld
Susan Jack
Tim Stokes
Joby George
Timothy Colbourn
Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review
BMJ Open
title Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review
title_full Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review
title_fullStr Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review
title_full_unstemmed Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review
title_short Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review
title_sort impact of health system governance on healthcare quality in low income and middle income countries a scoping review
url https://bmjopen.bmj.com/content/13/12/e073669.full
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