Co-Chairs Of CORE M&E Working Group Discuss Observational Bias In Health Quality Research

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Allison Annette Foster, senior adviser for human resources for health at IntraHealth International; Mai-Anh Hoang, public health specialist at Chemonics; and Todd Nitkin, senior adviser at World Vision International, all co-chairs of the CORE Monitoring & Evaluation Working Group, discuss results from the recent Lancet Global Health Commission report on high-quality health systems and highlight the observational bias that can occur when measuring quality of care and health system performance. The authors write, “The streetlight effect is a type of observational bias that occurs when we search for something only where it is easiest to look. Coverage, utilization, and access have been easier to quantify — and they are important health systems indicators — but they do not adequately measure quality of care and health system performance. … This means we have to venture outside of the light and work a little harder to find the answers…” (10/17).