Evolution of the concept of quality of care with respect to clean delivery in health systems in high, middle and low income countries: Systematic Literature Review

In order to function adequately and to lead to improvements in health outcomes such as low rates of maternal mortality, a health system mot only requires adequate resources in terms of finances, health care personnel, equipment and facilities, but also a well developed culture of quality management and quality assurance mechanisms, paying attention to patient safety, effectiveness and timeliness of interventions, responsiveness to patients, and equity. This review aimed to examine the changes over time in attention to quality in health systems at different stages of development, namely Malaysia (a middle income country with a well developed health system), India (a middle income country with a better developed health system that still faces significant challenges), and Ethiopia (a low income country with a poorly developed health system).