Innovations to Expand Access and Improve Quality of Health Services

Authors: Lori Bollinger, Margaret Kruk


This describes the existing non-community based health care service delivery mechanisms for reproductive, maternal, newborn, and child health (RMNCH), discussing (1) different ways of organizing service delivery, including innovative approaches and their impacts on the quality of services delivered; (2) different ways of organizing service delivery for RMNCH, including task-shifting, as well as examples unrelated to personnel; (3) coverage gaps and efforts to boost coverage; and (4) innovations to improve quality. Although evidence exists regarding the benefits of increasing coverage with innovative methods, little support is available on the effects of this increased coverage on quality, and despite growing awareness of serious quality deficits, research on interventions to improve quality has not produced clear guidance on what works and which models improve quality at scale. As the epidemiology of RMNCH shifts to more complex causes, insufficient quality of care will prove an increasing barrier to reducing mortality and morbidity and to achieving global health goals.



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