ReviewBMJ global health2026
Assessing the quality of care in low- and middle-income countries: a rapid review of the landscape of assessment tools.
Review in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite its broad conceptual scope, the Donabedian model (input-process-outcome) remains one of the most widely used frameworks for evaluating quality of care globally. Numerous tools have been developed to operationalise this model, yet no synthesis has focused specifically on those applied in low-resource settings or examined their validity and applicability in real-world settings.
objectiveThis study sought to review the landscape of tools used to assess each component of quality of care-according to Donabedian's model-in low- and middle-income countries (LMICs), and to evaluate their reported validity and applicability in routine health system settings.
methodA rapid review was conducted from June to November 2023. The following databases were searched using English and/or French keywords with no time limitation: Google Scholar and PubMed.
resultsA total of 1451 articles were retrieved from PubMed (n=1164) and Google Scholar (n=287), with an additional 74 articles identified through Google. After title, abstract and full-text screening, 85 studies met the inclusion criteria. The review identified a wide range of tools used to assess quality of care in LMICs, characterised by considerable variation in the aspects of quality of care covered, the types of tools and the assessment techniques applied. These tools were categorised as institutional-such as Services Availability and Readiness Assessment, Demographic and Health Surveys (DHS) and Patient Satisfaction with Nursing Care Quality Questionnaire-or investigator-developed, often tailored to particular contexts. While most tools focused on input and process components, outcome measures-especially objective health outcomes-were under-represented. Gaps were also noted in the reporting of tool validation and cost-effectiveness, with few tools integrated into routine health system practices.
conclusionsThis review highlights the need for context-appropriate, validated and cost-effective tools for assessing quality of care in LMICs. Tools should be user-friendly and embedded within routine monitoring systems to better support continuous quality improvement.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.