Quality in Health Care: 10 Key Lessons

In February of 2025, we gathered to celebrate ten years of work by the Salud Mesoamerica Initiative, a strategy that has enabled us to strengthen maternal and child health care for the most vulnerable populations in eight countries: Belize, Guatemala, Panama, Costa Rica, El Salvador, Honduras, Nicaragua, and the state of Chiapas in Mexico.

During the event, I had the privilege of moderating a panel on quality in health systems with Rashad Massoud, Jafet Arrieta, andPedro Bernal, three leaders in health and public policy with extensive international experience—especially in Latin America and the Caribbean—in improving the quality of care in health systems.

Quality of care is a major challenge in the countries of the region. A study estimated that 7 out of 10 excess deaths in our region could be prevented by quality of care and that 3 out of 10 are related to quality of care.

In this article, we share 10 lessons for improving the quality of care that we identified from the conversation.

10 lessons for improving the quality in health care

1. Quality improvement should not be seen as an isolated intervention, but rather as a system-wide effort to ensure that the right care is provided at the right time.
2. The quality of care must consider all its dimensions: it must be people-centered, effective, timely, efficient, safe, equitable, integrated, and sustainable, combining evidence-based medicine and a culture of continuous improvement.
3. Context matters: each country and health setting require tailored solutions; there is no universal formula.
4. Data collection alone does not improve health care; it is crucial to act on findings and not just use data for reporting.
5. Collaboration between different levels of the system and different areas is essential to achieve significant improvements.
6. Quality improvement must be integrated into the daily work of health professionals and supported by strong leadership at all levels; it is not the job of a few people for a few days.
7. Improvement is everyone’s job, from local professionals to health policymakers.
8. The following are essential: empowering supervision, characterized by a more horizontal relationship between supervisor and supervisee, based on collaboration, support, and guidance; intrinsic motivation linked to health practice, reflecting health personnel’s genuine interest in their work; and a non-punitive learning culture, focused on identifying problems in processes rather than assigning blame.
9. The concept of “health co-production,” understood as the interdependent work between users and health professionals in relationships and actions that contribute to the well-being of individuals and populations, highlights the active role of individuals and their communities in improving health. It also positions people-centered care as a cross-cutting axis in all dimensions of quality.
10. Improvement is a natural process: just as a child learns not to touch fire after a painful experience, health systems must learn from their mistakes and make quality improvement an easy and accessible path for all.

These 10 lessons show that improving quality is not only urgent, but also possible. It is crucial to remember that quality improvement is not a destination, but a continuous journey that requires the commitment of all actors in the health system. From health professionals to policymakers, everyone has a vital role to play in creating an environment where quality of care is the norm, not the exception. To learn more about these lessons, the full video of the session—along with other featured conversations—is available on the Salud Mesoamerica Initiative page.