Oxytocin, clinical outcomes, and patient choice, in resource constrained settings

There’s an inherent tension between creating quality standards that are very clinically focussed, and standards which are very patient centred - especially in settings where clinical outcomes can be compromised by basic lack of resources.  The use of oxytocin to prevent bleeding after birth is an example of this - WHO quality guidelines clearly measure and incentivise use of the drug, but in more wealthy healthcare systems, adherence patient preference is the key measure. How can we ensure that less wealthy healthcare systems are also patient centred?   Our guests for this discussion; Nana Twum-Danso, ​senior vice president, Institute for Healthcare Improvement (IHI) Paul Dsane-Aidoo, health specialist, UNICEF Ghana Keith Cloete, head of department at Western Cape Government: Health Hosted by Emma Veitch, Collections editor for The BMJ   This podcast is part of The BMJ Quality of Care collection, in collaboration with the World Health Organization and the World Bank, which offers critical thinking on both the unfinished agenda and emerging priorities for improving quality of care in low- and middle-income countries. 00:00 Introduction to the podcast 00:48 Introduction of experts and their backgrounds 02:54 Challenges in healthcare systems: south africa's perspective 04:15 The importance of patient-centred care 04:56 The role of data in improving quality of care 06:11 Community engagement and feedback in healthcare 07:58 Tackling global disparities in healthcare 08:41 Balancing clinical outcomes and patient-centred care 10:58 Addressing inequities in healthcare 22:43 The role of governance in improving quality of care 32:56 Overcoming resource constraints in healthcare 36:22 The need for system redesign in healthcare 37:18 Adapting to changing times in healthcare