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[Comment] Political and technical barriers to improving quality of health care

With the currently renewed emphasis on universal health coverage, the study by Margaret Kruk and colleagues1 in The Lancet is a timely reminder of the need to examine inadequacies in both access to and quality of health care.2 Their key finding that poor quality of health care is a major driver of excess mortality in low-income and middle-income countries (LMIC) will not surprise those working in such settings.3 However, the authors’ quantitative comparison indicating that improvements in the quality of health services would have a greater overall effect on mortality than expansion of service coverage (without attention to quality) provides new evidence to inform the resource allocation strategies of health policy makers and funding agencies.

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