Local perceptions on factors influencing the introduction of international healthcare accreditation in Pakistan

Datos Bibliográficos

ID11490269
AutoresSylvia Sax (Heidelberg University, autor de correspondencia), Michael Marx (0000-0001-9757-7057, Heidelberg University)
Año2014
Volumen29
Número8
Páginas1021-1030
Fecha de publicación2014-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czt084
PMID24226171
OpenAlexW2138773230
IdiomaEN
Citas recibidas4
Referencias citadas54

One contributor to poor health outcomes in developing countries is weak health systems; key to strengthening them are interventions to improve quality of health services. Though the value of healthcare accreditation is increasingly recognized, there are few case studies exploring its adaptation in developing countries. The aim of our study in Pakistan was to identify perceived factors influencing the adaptation of international healthcare accreditation within a developing country context. We used qualitative methods including semi-structured interviews, a structured group discussion, focus groups and non-participant observation of management meetings. Data analysis used a grounded theory approach and a conceptual framework adapted from implementation science. Using our conceptual framework categories of 'inner' and 'outer' setting, we found six perceived inner health system factors that could influence the introduction of healthcare accreditation and two 'outer' setting factors, perceived as external to the health system but able to influence its introduction. Our research identified that there is no 'one size fits all' approach to introducing healthcare accreditation as a means to improve healthcare quality. Those planning to support healthcare accreditation, such as national and provincial ministries and international development partners, need to understand how the three components of healthcare accreditation fit into the local health system and into the broader political and social environment. In our setting this included moving to supportive and transparent external evaluation mechanisms, with a first step of using locally developed and agreed standards. In addition, sustainable implementation of the three components was seen as a major challenge, especially establishment of a well-managed, transparent accreditation agency able to lead processes such as training and support for peer surveyors. Consideration of local change mechanisms and cultural practices is important in designing a local accreditation approach. The results of our study are important for health systems strengthening in Pakistan and in other developing countries.

Accreditation · Business · Conceptual framework · Context (archaeology) · Focus group · Geography · Health care · Medical education · Political science · Psychological intervention · Public relations · Qualitative research · Quality (philosophy) · Sociology · Healthcare Quality and Management · Marketing · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes