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1 Regular measurement of quality of care is a core principle of quality improvement programmes that has been promoted in some low resourced settings as the primary means to improve quality of healthcare- that is, the degree to which health services for individuals and populations are effective, safe, and people centred.

Correspondence to: M Muzigaba muzigabamwho.intĪmbrose Agweyu and colleagues argue that large scale improvements in quality of healthcare require strong change management as well as health information systems that can provide continuous and rapid feedbackĮvidence on the detrimental effect of low quality health systems on preventable mortality worldwide has accelerated investments in large scale healthcare improvement.

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7World Health Organization Country Office, Free Town, Sierra Leone.6Data and Analytics Section, Unicef, New York, USA.5School of Public Health, University of the Western Cape, Bellville, South Africa.4Department of Maternal Newborn, Child, and Adolescent Health, and Ageing, World Health Organization, Avenue ApGeneva, Switzerland.3Jhpiego, Baltimore, Maryland 21231, USA.2Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.1Department of Epidemiology and Demography KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.Moise Muzigaba, quality of care metrics technical lead 4.Binyam G Hailu, reproductive, maternal, newborn, child, and adolescent health lead 7,.Debra Jackson, Takeda chair in global child health 2 5 6,.Theresa Diaz, unit chief for epidemiology, monitoring and evaluation 4,.Kathleen Hill, senior technical adviser for quality 3,.

Ambrose Agweyu, professor of infectious disease epidemiology 1 2,.