There’s an inherent tension between creating quality standards that are very clinically focussed, and standards which are very patient centred - especially in settings where clinical outcomes can be compromised by basic lack of resources. 

The use of oxytocin to prevent bleeding after birth is an example of this - WHO quality guidelines clearly measure and incentivise use of the drug, but in more wealthy healthcare systems, adherence patient preference is the key measure.

How can we ensure that less wealthy healthcare systems are also patient centred?

Our guests for this discussion;

Nana Twum-Danso, ​senior vice president, Institute for Healthcare Improvement (IHI)

Paul Dsane-Aidoo, health specialist, UNICEF Ghana

Keith Cloete, head of department at Western Cape Government: Health

Hosted by Emma Veitch, Collections editor for The BMJ

This podcast is part of The BMJ Quality of Care collection, in collaboration with the World Health Organization and the World Bank, which offers critical thinking on both the unfinished agenda and emerging priorities for improving quality of care in low- and middle-income countries.

00:00 Introduction to the podcast

00:48 Introduction of experts and their backgrounds

02:54 Challenges in healthcare systems: south africa's perspective

04:15 The importance of patient-centred care

04:56 The role of data in improving quality of care

06:11 Community engagement and feedback in healthcare

07:58 Tackling global disparities in healthcare

08:41 Balancing clinical outcomes and patient-centred care

10:58 Addressing inequities in healthcare

22:43 The role of governance in improving quality of care

32:56 Overcoming resource constraints in healthcare

36:22 The need for system redesign in healthcare

37:18 Adapting to changing times in healthcare