How can patients in resource-limited settings participate in service improvement initiatives?

1 Involve patients in co-design and co-production

One way to ensure that service improvement initiatives are relevant, responsive, and respectful of patients' needs and preferences is to involve them in co-design and co-production. Co-design is a collaborative approach that engages patients, along with healthcare providers, managers, and other stakeholders, in the planning and design of service improvement projects. Co-production is a similar approach that extends the involvement of patients to the implementation and evaluation of service improvement projects. By involving patients in co-design and co-production, healthcare organizations can tap into their lived experiences, insights, and feedback, and empower them to shape the services that affect them. For example, in Uganda, a co-design project involving patients, community health workers, and researchers led to the development of a mobile phone-based system to improve maternal and newborn health outcomes in rural areas.

2 Support patients to form groups and networks

Another way to facilitate patient participation in service improvement is to support them to form groups and networks that can advocate for their rights, interests, and needs. Patient groups and networks can provide a platform for patients to share their experiences, challenges, and solutions, and to amplify their voices and influence. They can also enable patients to access information, education, and peer support, and to collaborate with other stakeholders in service improvement. For example, in Malawi, a network of people living with HIV/AIDS was established to improve the quality of HIV care and treatment services. The network engaged in various activities, such as conducting patient satisfaction surveys, providing feedback to healthcare providers, and participating in quality improvement teams.

3 Train patients to become improvement agents

A third way to enhance patient participation in service improvement is to train them to become improvement agents. Improvement agents are individuals who have the skills, knowledge, and motivation to initiate and sustain service improvement projects. By training patients to become improvement agents, healthcare organizations can equip them with the tools and methods to identify and address gaps and problems in their care processes, and to monitor and measure the impact of their improvement actions. They can also foster a culture of continuous learning and improvement among patients and their peers. For example, in India, a training program for patients with chronic kidney disease taught them how to use quality improvement tools, such as process mapping, cause-and-effect analysis, and plan-do-study-act cycles, to improve their self-management and care coordination.