What is Quality of Care and How Do We Measure It?

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By: Katie Millar, Technical Writer, Women and Health Initiative, Harvard T.H. Chan School of Public Health

As I’ve read through the excellent guest posts of “Supporting the Human in Human Resources” series, I’ve often thought, “Yes, we need well-trained health providers to ensure quality care, but what is quality care and how do we measure it?” Of course there are the well-known indicators like maternal mortality ratio (MMR) and percentage of women that give birth in a facility, but these indicators are high level and take expensive surveys. What should we be measuring at the facility and community level?

In The Lancet’s Midwifery series, the authors present a framework for quality maternal and newborn care. At the foundation, they identified the need to provide information and education to enable women to seek quality care. In addition, health professionals with clinical, interpersonal and cultural knowledge and skills need to give women respectful maternity care. While everyone working in maternal and newborn health would agree with that conclusion, what are the specificities and how are they measured and managed?


To answer this question, the WHO recently released, Consultation on improving measurement of the quality of maternal, newborn and child care in health facilities. This document explores the need for global quality assurance standards, since many countries do not have accreditation or monitoring systems to assess and ensure quality of care at health facilities. To fill this need, global consultations formulated indicators for maternal, newborn, and child health. The document also details lessons learned in monitoring and evaluation and a literature review to support the proposed indicators.

Please find below this resource and others for assessing quality of care from facility to national levels.

WHO Indicators and Recommendations

Other Sources for Indicators and Recommendations

National Level Quality Measurement

National to Facility Level Quality Measurement

Facility Level Quality Measurement