Crossing the quality chasm in resource-limited settings

Duncan Smith Rohrberg Maru, Jason Andrews, Dan Schwarz, Ryan Schwarz, Bibhav Acharya, Astha Ramaiya, Gregory Karelas, Ruma Rajbhandari, Kedar Mate, Sona Shilpakar

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations


Over the last decade, extensive scientific and policy innovations have begun to reduce the " quality chasm" - the gulf between best practices and actual implementation that exists in resource-rich medical settings. While limited data exist, this chasm is likely to be equally acute and deadly in resource-limited areas. While health systems have begun to be scaled up in impoverished areas, scale-up is just the foundation necessary to deliver effective healthcare to the poor. This perspective piece describes a vision for a global quality improvement movement in resource-limited areas. The following action items are a first step toward achieving this vision: 1) revise global health investment mechanisms to value quality; 2) enhance human resources for improving health systems quality; 3) scale up data capacity; 4) deepen community accountability and engagement initiatives; 5) implement evidence-based quality improvement programs; 6) develop an implementation science research agenda.

Original languageEnglish (US)
Article number41
JournalGlobalization and health
StatePublished - Nov 30 2012
Externally publishedYes


  • Global health
  • Health system
  • Quality improvement
  • Resource-limited

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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