Conclusion

This concluding chapter summarizes learning from a selection of case studies on improving health care in low- and middle-income countries. This selection of quality improvement (QI) cases exposes students and practitioners to real examples of what health-care improvement efforts can achieve. While not glossing over difficulties, the cases presented seek to show how real teams and organizations dealt with challenges in QI implementation. These 12 cases illustrate the range of settings in which QI methods are effective and focus on different aspects of QI intervention design and implementation. Together, they paint a comprehensive pic-ture of how QI methods have been applied to improve health care in low- and mid-dle-income countries at all levels of the health system and show how different QI methods can be applied by health workers at each level. The cases also offer important insights into factors that facilitate results: a focus on reaching explicit standards, engaging health workers in identifying gaps in meeting standards and taking action to address the gaps, management support for QI and for intervening in the selected care area, tools to support data analysis, and facilitating friendly competition and sharing learning among improvement teams.