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Kevin Croke and colleagues consider how demand for quality health systems can be made a political and public priority to drive change in low and middle income countries The root causes of gaps in quality of care in the health systems of low and middle income country generate considerable debate, and opinions differ about how to tackle these gaps. The debate is illustrated by three important reports published in 2018.123 The consensus view of major global health institutions is well captured by the 2018 report from the World Health Organization, World Bank, and Organisation for Economic Cooperation and Development, which emphasised technical strategies to improve system quality such as changes to payment systems, adoption of new technologies, and scale-up of facility level quality improvement interventions. This approach is consistent with most published evidence in the quality improvement field, which explicitly or implicitly takes the same approach. The Lancet Global Health Commissio

Addis ababaAmit aryalKevin crokeRegina kamogaEmma veitchJuan francoMargarete krukSudip pokhrelJennifer rasanathanGagank thapaQuality evidence for health system transformation networkMelinda gates foundationEthiopia public health instituteWorld health organizationOrganisation for economic cooperationMinistry of health