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. 2019 Nov 30;31(9):G133-G135.
doi: 10.1093/intqhc/mzz066.

Quality health care in extreme adversity-an action framework

Sheila Leatherman  1 , Linda Tawfik  1 , Dilshad Jaff  1 , Grace Jaworski  1 , Matthew Neilson  2 , Shamsuzzoha Babar Syed  2 , Mondher Letaief  3
Affiliations

Quality health care in extreme adversity-an action framework

Sheila Leatherman et al. Int J Qual Health Care. .

Abstract

Quality problem or issue: There are record-setting numbers of people living in settings of extreme adversity and they continue to increase each year.

Initial assessment: There is a paucity of validated data on quality and safety across settings of extreme adversity.

Choice of solution: This paper argues for an action framework to address the unique challenges of providing quality in extreme adversity.

Implementation: We describe a preliminary Quality in Extreme Adversity framework which has been informed by-and will continue to be validated through-literature, data collection, WHO expert consultations and through working in settings of extreme adversity with national authorities and NGOs.

Lessons learned: Poor quality care costs lives, livelihoods and trust in health services. The recommended framework, based on evidence and experiential lessons, intends to address the WHO goal for 2019-2023 of 'one billion people better protected from health emergencies' (9).

Keywords: action framework; extreme adversity; fragile, conflict, and violent settings; health care quality.

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