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Enhancing Quality of Congenital Heart Care Within Resource-Limited Settings
Shazia Mohsin1, Babar Hasan1, Bistra Zheleva2
1Division of Cardiothoracic Sciences, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.
Insights
Over 90% of children with congenital heart disease (CHD) are born in low-resource settings. This review proposes a quality improvement (QI) framework to enhance care and reduce deaths in these areas.
Area of Science:
- Pediatric Cardiology
- Global Health
- Healthcare Quality Improvement
Background:
- Congenital heart disease (CHD) disproportionately affects children in low- and middle-income countries (LMICs), where over 90% are born.
- Resource limitations and fragmented health systems in LMICs result in poor quality of care (QoC) for CHD patients, leading to adverse outcomes.
Purpose of the Study:
- To review common barriers to implementing effective quality improvement (QI) processes for CHD care in LMICs.
- To propose a QI framework tailored for resource-limited settings to improve patient outcomes and reduce mortality.
Main Methods:
- Literature review examining challenges in QI implementation within LMICs.
- Analysis of successful QI initiatives in LMIC contexts.
Main Results:
- Identified significant barriers to QI in LMICs, including resource scarcity and systemic issues.
- Highlighted successful strategies from existing QI programs.
Conclusions:
- Despite challenges, a practical QI framework can significantly improve CHD care and outcomes in LMICs.
- The proposed framework emphasizes simple, effective measures, collaborative efforts, and leadership commitment to QoC.
Abstract:
Over 90% of the world's children with congenital heart disease (CHD) are born in the resources poor settings of low- to middle-income countries (LMICs). The shortfall in human and material resources and dysfunctional health systems leads to poor quality of care (QoC) which contributes substantially to suboptimal outcomes of patients with CHD in LMICs. Notwithstanding these challenges, it is possible to develop a quality improvement (QI) framework that can have a significant impact on outcomes and prevent a number of deaths. In this review, we examine the common barriers to implementing effective QI processes in LMICs. Using examples of successful QI initiatives in LMIC, we propose a broad framework that focuses on simple, yet effective measures involving cohesive efforts of all key participants guided and nurtured by a leadership that strongly values QoC.
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