Quality and safety of health services is a critical issue for Pakistan. To address this, a delegation of WHO and international experts conducted a five day mission from 8 to 12 July 2019 in order to properly respond to the current challenging situation. The delegation visited hospitals in Islamabad, Lahore and Karachi and met with senior health leaders including the FederalHealth Minister, Provincial Health Minister for Punjab, and Health Secretary for Punjab and Sindh. They also held discussions with the Health Care Commissions of Punjab and Sindh. The delegation has shared its findings to the Special Assistant to the Prime Minister on Health Dr. Zafar Mirza on 12th July. Across Pakistan, while there was clear commitment to address quality and safety from health leaders and operational teams, many challenges should be given serious consideration and be effectively addressed. Priority areas requiring attention include compliance with evidence-based patient safety standards and norms (for example for infection prevention and control), regulation and registration of healthcare providers and facilities, development of a hospital culture that promotes open discussion of safety issues, and the need to improve primary health care to reduce the number of patients using hospitals. Some very important steps have already been taken, for example establishing the provincial healthcare commissions. Discussion between the Federal Ministry and the delegation has identified a list of priority actions. This includes completion of a comprehensive review of quality and safety across Pakistan; enrolling a group of hospitals in the Patient Safety Friendly Hospital Initiative and supporting them to meet the required standards; and developing a national policy and strategy for quality of healthcare, with close involvement of each of the provinces. To oversee all these efforts, a national steering committee for quality and safety will be created, supported by a network of focal points to support health facilities. The World Health Organization commits to continue working closely with the Ministry to provide ongoing support to improve quality and safety, raise awareness among the public and health workers, and ensure coordination of the various related initiatives. During the mission, a peer learning meeting was held, at which a representative from Oman shared experience of the Patient Safety Friendly Hospital Initiative with hospitals and health leaders from across Pakistan. Given the urgent need to address quality of care, patient safety, and infection prevention, we are pleased to accept the findings of the expert delegation and will work with WHO to implement the recommended actions and roadmap, said Dr. Zafar Mirza while speaking to the delegation. “I would like to commend the commitment of Dr Zafar Mirza to improve the quality and safety of health services across Pakistan. We are pleased that Pakistan is aspiring to join our regional movement on patient safety. WHO is committed to working with the national and provincial governments to implement the Patient Safety Friendly Hospital Initiative, develop a national policy and strategy for quality of healthcare, and improve infection prevention and control”, said Dr Mondher Letaief, WHO Eastern Mediterranean Regional Office. “It is critical to make sure health services are safe for the people they serve, and what we have learned in England is that unsafe care usually happens because of problems with the system, not with health workers. I have submitted my recommendations and look forward to following the progress of Pakistan as government, health workers and communities work together to develop a culture of quality and safety”, said Donna Forsyth, International Expert in Patient Safety.
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