Quality Evidence for Health System Transformation (QuEST) Network

In low and middle-income countries 5 million people die each year from treatable conditions despite seeking health care. This means that providing access to health services is not sufficient, but improving quality across the health system is needed. Together with Harvard University, regional research networks and Swiss academia, SDC supports the establishment of a global movement for innovative research to inform policy and cost-effective investments and to improve quality of health systems.

Pays/région Thème Période Budget
Monde entier
Renforcement des systèmes de santé
Système de santé primaire
Services médicaux
01.12.2018 - 31.12.2024
CHF 6'048'203

Evidence shows that 60% of all avoidable deaths (about 5 million people/year) in low and middle-income countries occur among people who actually accessed care. The response to the Covid-19 has revealed major gaps with regard to health systems’ capacity to adapt to shocks and provide quality care efficiently. Hence quality health systems that “optimize health care by consistently delivering care that improve or maintain health outcomes, by being valued and trusted by all people, and by responding to changing population needs” need to be built. Since its 2019 direct participation in the elaboration of Bellagio Declaration on High-Quality Health System[1], SDC promotes cost-effective investments and innovative research to improve quality of healthcare structural arrangements and delivery models. Yet, research and programming aiming at addressing quality have overwhelmingly focused on the service provision level, while the insufficient performance is largely attributable to complex structural, system-wide failures. In partnership with Harvard University, regional research networks and Swiss academia, SDC will support the creation of a global multi-stakeholder movement (the QuEST movement) that develops, tests and implements open-source products such as more manageable quality measurement tools and innovative evaluations of large-scale system improvement approaches.

[1] The Bellagio Declaration on High-Quality Health systems is a resolution adopted by 19 Institutions and governments in Bellagio (Italy) in June 2018.  As a result of the recommendations of the Lancet Commission on High-Quality Health Systems (see foot note 2). SDC was part of the advisory panel of such Commission and one of the first signatories to the declaration.

Objectifs The overall objective of the Quality Evidence for Health System Transformation (QuEST) Network is to improve the quality of health systems through operational research and to create a global community of practice to catalyse investments in evidence-based policy making on quality of health systems. 
Groupes cibles

Direct beneficiaries are:

- research institutes and health systems researchers in low and middle-income countries who will develop their skills and capacities in quality assessment and improvement methodologies

- governments that will benefit from relevant evidence on system quality to inform their policies.

Ultimately these investments as well as the continuous application of efficient and affordable assessment tools and innovation evaluations of large-scale health system improvements will benefit patients in low and middle-income countries through adopted health policies privileging higher quality of care according to population’s needs.

Effets à moyen terme

1. To build high quality evidence base and catalyze policy change for health system transformation in selected low and middle-income countries

2 To establish a global movement and research agenda related to quality of health systems


Principaux résultats attendus:  

The following key outputs will be achieved
in Phase I:
1.  The QuEST Network’s Core Group is
established with an operational platform
built at Harvard University managing a core
group of 4 low- and middle-income country-based
QuEST Centers.

2. The main steering bodies of the Core
Group are created and operationalized

3. A larger QuEST movement involving
other relevant stakeholders is set up and

4. Research communication and
dissemination tools are created.

5. Evidence is generated around three
methodological streams to achieve and
validate improvements in the quality of
health systems.

Principaux résultats antérieurs:  

The inception phase (CHF 149’000) mainly achieved results linked with the project’s setup and identification of the research streams:

1)   Governance arrangements and overall structure of the QuEST movement were defined

2)   Initial model of health systems’ redesign was tested in Tanzania

3)   Proof of concept for the use of technology to measure end users’ satisfaction was validated

4)   Partner countries and regions for setting up first QuEST centers were identified (Ethiopia, Kenya, India, South Africa, Latin America consortium in Argentina, South-East Asia consortium in China)

Direction/office fédéral responsable DDC
Crédit Coopération au développement
Partenaire de projet Partenaire contractuel
Institution universitaire et de recherche étrangère
  • Research Organisation of South East

Coordination avec d'autres projets et acteurs Collaboration is foreseen with the SDC supported program “Making the Most of Belt and Road for global health” and potentially P4H. New synergies will be elaborated as the QuEST movement grows.
Budget Phase en cours Budget de la Suisse CHF   6'048'203 Budget suisse déjà attribué CHF   1'279'000
Phases du projet Phase 99 01.11.2020 - 31.12.2026   (Phase en cours) Phase 1 01.12.2018 - 31.12.2024   (Phase en cours)