Considerable attention is being paid to improving quality of care in public health systems because of both the need to respond to customer concerns and cost consider ations. Many governments, following industrial organisations, have been attempting to implement total quality management (TQM). The experience of TQM implementa tion has been mixed, however. The paper reviews the Malaysian experience of imple menting TQM. It also reviews the experience of interventions to improve quality of care in family planning and reproductive health programmes to illustrate what is needed to improve quality of care for public health programmes. Based on the review the paper suggests that an incremental approach, realistic expectations, building on what exists, and persistence would result in reduced frustrations in improving quality of care and ultimately lead to TQM.
Get full access to this article
View all access options for this article.
References
1.
Ahmad Sarji bin Abdul Hamid (1995a). TQM in government: Towards an excellent public service. New Strait Times, 18 April.
2.
— (Chief Secretary to the Government) ( 1995b). Speech at the Regional Quality Forum at Subang, Selangor , Malaysia.
3.
AVSC International (1995). COPE: Client-oriented provider-efficient services: A process and tools for quality improvement in family planning and other reproductive health services. New York: AVSC International.
4.
Berman, Evan M., Michael E. Milakovich , and Jonathan P. West (1996). Implementing TQM in State Public Health Agencies. Journal of Health on Human Services Administration, Fall, 182-205.
5.
Berwick, Donald M., A. Blanton Godfrey and Jane Roessner (1990). Curing health care: New strategies for quality improvement. San Fransisco: Jossey-Bass Publishers.
6.
Brook, R.H., E.A. McGlynn and P.D. . Cleary (1996). Measuring quality of care. New England Journal of Medicine, 335, 966-70.
7.
Bruce, J. (1990). Fundamental elements of the quality of care: A simple framework. Studies in Family Planning, 21(2), 61-91.
8.
Casparie, Anton F., Emmy M. Sluijs, Cordula Wagner , and Dinny H de Bakker (1997). Quality systems in dutch health care institutions. Health Policy , 42, 255-67.
9.
Cleary, P.D. and S. Edgman-Levitan (1997). Health care quality: Incorporating consumer perspectives. Journal of the American Medical Association (hereafter JAMA ), 278, 1608-12.
10.
De Geyndt, W. (1995). Managing the quality of health care in developing countries. World Bank Technical Paper No. 258. Washington DC: The World Bank.
11.
Dohlie, Maj-Britt and Jay Satia (eds.) (1997). Population manager . Kuala Lumpur: ICOMP.
12.
Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Quarterly, 44, 166-203.
13.
— (1988). The quality of care: How can it be assessed?JAMA, 260(12), 1743-48.
14.
— (1990). The seven pillars of quality. Arch Pathol Lab Med, 114(1), 1115-18.
15.
Duran-Arenas, L.G. (1997). The continuous quality improvement program in the Mexican ministry of health. In Vahe A. Kazandjian (ed.) The effectiveness of CQI in health care: Stories from a global perspective . Milwaukee, WI:ASQC Quality Press.
16.
Economist , The (1992). The cracks in quality. 18 April, 63.
17.
Garvin, D.A. (1988). Managing quality: The strategic and competitive Edge. New York: The Free Press .
18.
Gebaly E.H., C. Brancich , and M.E. Shaffie (1994). Quality improvement programme (QIP) in the Ministry of Health, Egypt. In Satia J and ML Liow (eds.) Innovations, No. 1 (pp. 59-80). Kuala Lumpur: ICOMP.
19.
Halil, Hj. Jalal bin (1992). Review of progress of implementation of quality assurance in health services program. Presented at the National Quality Assurance meeting for state facilitators for the health services progamme. 16-18 September.
20.
Hoa, H.P., J. Yan and J. Satia (1997). Improving quality of care in Duy Tien district . In M.B. Dohlie and J. Satia (eds.) Population Manager. Vol. 5 (pp. 67-81). Malaysia: ICOMP.
21.
Jain, A. (1992). Managing quality of care in population programs . West Harford: Kumarian Press, and Kuala Lumpur: ICOMP.
22.
Johns Hopkins Centre for Communication Programs ( 1997). Egypt's goldstar quality program wins clients and communities . Communication Impact!, 4, November.
23.
Juarez, A.L. (1994). Continuous quality improvement programme (CQI) in the Catemaco Logistics Centre, Mexico. In Satia J. and M.L. Liow (eds.) Innova tions, No. 1. Kuala Lumpur: ICOMP.
24.
Juran, J.M. (1989). Juran on leadership for quality. New York: Free Press.
25.
Kolarik, W.J. (1995). Creating quality: Concepts, systems, strategies, and tools. Singapore : McGraw-Hill Book Company.
26.
Medical Services Division and Public Health Institute (1990). Report: quality assurance workshop for co-ordinators and medical superintendents. Part I: 12-17 February and Part II: 11-14 March . Kuala Lumpur: MOH.
27.
Government of Malaysia. (1990). Quality assurance for family health program. Kuala Lumpur : Ministry of Health, Health Services Division Bahagian Kesihatan Kementerian Kesihatan Malaysia (MOH).
28.
— ( 1993). The Client's Charter. Kuala Lumpur : MOH.
29.
Nicholas, D.D. (1997). Results of CQI in Africa: The Niger experience . In Vahe A. Kazandjian (ed.) The effectiveness of CQI in health care: Stories from a global perspective. Milwaukee, WI: ASQC Quality Press.
30.
Ominde, Achola (1997). Improving quality of care in Kenya using situation analysis in review of experiences in improving quality of care. In Dohile MB, Satia J. (eds.) Population Manager, Vol. 5 (pp. 81-109). Malaysia: ICOMP .
31.
Ramana, G.N.V., R. Devi , M. Prakasamma, S. Ramidamy , M.B. Dohlie and J. . Satia (1997). Improving quality of care at Shamirpet primary health centre, Andhra Pradesh. In M.B. Dohile and J. Satia (eds) Population Manager, Vol. 5 (pp. 23-42). Kuala Lumpur: ICOMP.
32.
Ryan, Mary Jean and William P. Thompson (1998). CQI and the renovation of an American health care system: A culture under construction. Milwaukee, WI: ASQ Quality Press.
33.
Satia, J. and M.B. Dohlie (1995). Total quality management in Malaysia's government health services. Paper written as background material for the seminar Implementing Population Programmes: Quality of Reproductive Health Care as the Way Forward organised by the World Bank, UNFPA and ICOMP in Kuching, Sarawak, Malaysia, November.
34.
Suleiman, Abu Bakar (1995). What is quality? What does it mean to me? What are my expectations? (from the funder perspective). Presentation at the 12th International Society for Quality in Health Care, St. John's Newfoundland, Canada, 31 May-2 June.
35.
Wickramasuriya K., V. Karunaratne, A. Fonseka , C. . Gamage, C.D. Amarasekara, S.B. Abeyakoon, Maj-Britt Dohlie and Jay Satia (1997). Focusing on clients: Improving QOC at Eheliyagoda . In M.B. Dohile and J. Satia (eds.) Population Manager, Vol. 5 (pp. 43-65). Kuala Lumpur: ICOMP.
36.
World Health Organisation (WHO) (1994). Report of the WHO working group on quality assurance. District Health Systems, Division of Strengthening Health Services, May. Geneva : WHO.
37.
Young, Gary J., Martin P. Charns and Galen L. Barbour (1997). Quality improvement in the US veterans health administration. International Journal for Quality in Health Care, 9(3), 183-88.
