Coproducing Quality and Safety Improvement Projects in Resource-Constrained Countries: Lessons From Mozambique.

Objectives: Mozambique is a large country with low GDP and dispersed population. The health service has limited human and physical resources. These constraints have the potential to result in poor quality of care with an impact on patient safety and person experience. Methods: This paper is a "before and after" assessment of a quality and safety improvement project based on a qualitative and quantitative review. Results: Four case studies illustrate the success of the programme with gains in terms of reduction of maternal death and Key lessons are that aid agencies need to coproduce solutions with the local MoH and clinical teams so that there is ownership of the programme. Thus, all interventions need to be financially light, i.e., aiming to achieve success with minimal funding, so that when the programme ends there is a sustainable plan that can be maintained. Conclusion: In this review of quality improvement initiatives in Mozambican hospitals we have demonstrated the potential to enhance patient outcomes despite resource constraints. The key to the success of the initiative has been collaborative work as equal partners.