Partnership defined quality: A community-based approach to address socially determined barriers to care

Save the Children (SC) developed Partnership Defined Quality (PDQ) methodology in 2002 to improve access and quality of community level health services. PDQ builds social capital using a Community Action Cycle model. Unique among quality improvement approaches, PDQ engages both users and nonusers of health services alongside providers to identify barriers to access and quality health services, and to problem solve to overcome these barriers using existing local resources. Participants become empowered as they jointly design, implement and monitor these interventions. PDQ is rights-based, in that it makes the duty bearers (providers) more accountable to clients (community members). Three program examples demonstrate pre-post improvements in provider capacity and facility environment leading to improved client satisfaction, demand, provider performance and sustainability of services. Two examples compare “PDQ communities” versus “non-PDQ communities.” PDQ has been implemented in fifteen countries regarding maternal, child and adolescent health. Scale has been achieved in three countries, with many successes yet significant challenges due to labor intensive local processes. More rigorous evaluation of PDQ alone and as complement to other methods is needed to demonstrate effectiveness.