Quality of care for pregnant women and newborns – the WHO vision

With the growing use of health facilities to give birth, ensuring that women receive quality of care is essential. This article presents the World Health Organization’s (WHO’s) vision of quality of care for maternal and newborn health (MNH): a world where ‘every pregnant woman and newborn receives quality care throughout pregnancy, childbirth and the postnatal period’. This vision is underpinned by two global action plans:

1. Strategies toward Ending Preventable Maternal Mortality
2. Every Newborn Action Plan 

Taking influence from a variety of seminal approaches to understanding quality of care (e.g. Hulton and colleagues (2000) and Donabedian (2005)), the WHO has developed a framework for the quality of care for pregnant women and newborns in health facilities and a supporting strategy to ensure continuous quality improvement. In this article, the authors outline both the framework and strategy as part of their vision on quality of care for MNH.The WHO defines quality of care as ‘the extent to which health care services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, health care needs to be safe, effective, timely, efficient, equitable, and people-centred’ (page 2).Quality of care is understood to be a multi-dimensional concept for the WHO. The framework presents dimensions of quality of care which can be targeted for improvement. The overarching structure is the health system. Within this structure, the process of care takes place across two inter-linked dimensions:  1) the provision and 2) experience of care. These dimensions consist of eight domains and result in improved outcomes: Provision of care:1)     Evidence based practices for routine and emergency care;2)     Actionable information systems3)     Functional referral systems Experience of care:4)     Effective communication5)     Respect and dignity6)     Social and emotional support Cross-cutting:7)     Competent and motivated human resources8)     Essential physical resourcesThese domains of quality of care should be the focus of the assessment, improvement and monitoring of care within the health system.The quality of care improvement strategy is based on the “Plan-Do-Study-Act” cycle. It provides aims and suggested interventions to ensure that implementation of the quality of care vision is maintained.The WHO aims to use this framework and strategy to develop guidance for global and national stakeholders on how to implement the WHO’s vision of quality of care for MNH.To read the WHO’s vision on quality of care for free, click here. To learn about the WHO Quality Equity Dignity initiative (QED) and the Quality of Care Network click here and here.Tuncalp, Ӧ., Were, W.M., MacLennan, C., Oladapo, O.T., Gülmezoglu, A.M., Bahl, R., Daelmans, B., Mathai,M., Say, L., Kristensen, F., Temmerman, M., Bustreo, F. (2015). Quality of care for pregnant women and newborns—the WHO vision. BJOG, 122(8), 1045–1049