Azeem Sultan Mir, Raees Malik, Asifa Khanum.
Improving quality of health care in economically constrained settings: a systematic literature review.
Pak J Public Health Jan ;2(1):66-70.

Introduction: Lack of financial resources and trivial sensitization of healthcare professionals are commonly known as the reasons behind inadequate quality of healthcare services in countries with poor health indicators. Therefore there is need to introduce cost effective health management initiatives with strategic focus on sensitization of healthcare providers. Objectives: This literature review attempts to identify cost effective strategies described in scholarly articles and sensitize service providers and managers to quality management issues. Methods: Literature search was carried out in databases including PUBMED, MEDLINE, and COCHRANE LIBRARY. Both MeSH and non-MeSH terms were used to identify the articles. The search strategy was limited to include articles published after 1990. Forward citation tracking was also pursued. Furthermore, individual experts from Universities of Wollongong, New South Wales and Dhaka were contacted to provide additional literature. From the 9943 relevant articles, 96 were selected for review. Results: Quality Management in Health does not necessarily have to be resource intensive. Several cost effective strategies have been identified from the literature. These can help managers initiate Quality Management at facility level. These strategies require few resources but substantial investments in terms of commitment and attitudinal changes. Conclusion: The literature promises enormous dividends. The time has finally come, for introduction of health quality management initiatives, in developing countries.

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