Health system quality in the time of COVID-19

As low-income countries in sub-Saharan Africa respond to coronavirus disease 2019 (COVID-19), underlying health system quality must be carefully considered and included in the design and delivery of services. What works in high-income settings might not translate to low-income countries if the quality of health care at baseline is poor and, although steady and impressive progress on quality has been made in some low-income countries,1 concerning gaps remain. Studies show that providers in these contexts often perform less than half of the most basic elements of a high-quality visit; equipment and supplies continue to be a challenge; and clinical outcomes directly amenable to high-quality care, such as early neonatal mortality, continue to be poor.