ABSTRACT
This is the third book in a series on international health systems reform. The first book, Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries, documented the reform efforts of multiple countries at national levels. It examined a question pertinent to all health systems wanting to improve the care they provide: What is the relationship between quality and safety initiatives at the meso- and micro‑levels of systems, and the macro‑level reforms that key stakeholders are striving to achieve in the long‑term, aiming at change and improvement across the whole of their system? The cases examined in this book revealed that strategic initiatives are frequently not related. National-level reforms often go on, disconnected from the middle- and lower-level changes envisaged under the quality and safety umbrella. The take-home message was that national initiatives require intersectoral effort, and that evaluation of reform activities and improvement measures is all too often neglected. Improvement, in summary, is too often assumed and not sufficiently measured or evaluated (Braithwaite et al., 2015 , 2016).
