Poor quality health services are holding back progress, according to a new joint report by the OECD, World Health Organization (WHO) and the World Bank. This is not new information but a new report has summarized and quantified how dangerous poor healthcare can be for a country and its citizens.
Health systems in low-income countries, including Sierra Leone, feature inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise.
Mary Kamara was diagnosed with malaria and typhoid in early July 2018. She said, “The doctor and nurses told me… but I know how malaria feels and I was sure it wasn’t malaria. They prescribed some sort of drip (I.V.), Lokmal and an antibiotic.” Kamara visited a private clinic where she was diagnosed with a viral infection – not malaria and typhoid. She was treated appropriately after an accurate diagnosis… and recovered in a week or so.
“Good health is the foundation of a country’s human capital, and no country can afford low-quality or unsafe healthcare,” World Bank Group President Jim Yong Kim said. “Low-quality care disproportionately impacts the poor, which is not only morally reprehensible, it is economically unsustainable for families and entire countries.”
The report, “Delivering Quality Health Services – a Global Imperative for Universal Health Coverage,” features frightening statistics for low-income countries and the health of their citizens. Sickness associated with poor quality health care also costs more for families and health systems. And, the broader economic and social costs of poor quality care, including long-term disability, impairment and lost productivity, are estimated to amount to trillions of dollars each year.
Joshua Lavali of Freetown, said, “I was diagnosed with a hernia but when I went for treatment I was told I had to have surgery. I ended up missing several weeks of work and my family had to pay for all my healthcare and my time in the hospital.” In Sierra Leone, we suffer because we don’t have access to good healthcare, he continued.
The Report also noted, 10% of hospitalized patients can expect to acquire an infection during their stay. Health care workers made mistakes in diagnosing problems three out of four times. Clinical guidelines were applied only 45% of the time leaving too much room for error.
Just 28% of antenatal care, 26% of family planning services and 21% of sick-child care qualified as “effective.” In other words, more than 75% of the time, healthcare for children and pregnant women was ineffective or substandard.
High quality healthcare involves the right care, at the right time, in the right place, and by the right care provider, while minimizing harm and resource waste and leaving no one behind. Unfortunately, Sierra Leone fails to meet these requirements and struggles to provide basic healthcare services that deliver value to patients, are safe, and meet the needs and preferences of patients.
Governments should lead the way with strong national health care quality policies and strategies. Health systems should focus on competent care and user experience to ensure confidence in the system. Citizens should be empowered and informed to actively engage in health care decisions and in designing new models of care to meet the needs of their local communities. Health care workers should see patients as partners and commit themselves to providing and using data to demonstrate the effectiveness and safety of health care.
“Without quality health services, universal health coverage will remain an empty promise,” said OECD Secretary-General Ángel Gurría. “The economic and social benefits are clear and we need to see a much stronger focus on investing in and improving quality to create trust in health services and give everyone access to high-quality, people-centred health services.”
Striving for universal quality health coverage is not just an investment in better health—it is a commitment to building a healthier and more productive society.
All citizens and patients should:
·be empowered to actively engage in care to optimize their health status;
·play a leading role in the design of new models of care to meet the needs of the community;
·be informed that it is their right to have access to care that meets modern standards of quality; and
·receive support, information and skills to manage their own long-term conditions.
“At WHO we are committed to ensuring that people everywhere can obtain health services when and where they need them,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “We are equally committed to ensuring that those services are good quality.”
SD/21/7/18
Monday July 23, 2018.
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