Diego Rios-Zertuche

FYI: You are posting your address and instructions… if someone screenshots and shares your message, you could be getting many more postcards!

A clear takeaway: we must bridge the gap between evaluators and implementers—especially in how we communicate evidence to policymakers.

The @saludmesoamerica.org continues to offer deep lessons in health systems transformation.

#PublicHealth #HealthSystems

Key insights:
🔹Internal vs. external evaluation—call to involve evaluators earlier
🔹Improved perfomrance of primary care teams—community outreach as a key mechanism
🔹Measuring systems performance—interdisciplinary, relational, holistic approaches

#Evaluation #ImplementationScience

Seminar panel discussion with Leslie Curry, Wolfgang Munar, Emma Iriarte, Alicia Menendez and Pedro Bernal.

Pleased to attend the inaugural seminar at the @gw-glc.bsky.social: “Learning from Systemic Change Over Time – The @saludmesoamerica.org 2011–2024.”

Thanks to @wmunar.bsky.social, Emma Iriarte, Alicia Menendez, Leslie Curry & Pedro Bernal for the fun dialogue.

#HealthSystems #publichealth

Matilde Neret, Nubia Prada and Diego Rios-Zertuche wearing medical scrubs.

I left inspired by the exceptional work of the Instituto Nacional de Cancerología, and by professionals like Nubia, who work behind the scenes to provide high quality care.

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That’s where I met Nubia Prada, who built and now runs the unit. Her first words: “Wash your hands well. Don’t touch the glass.” With precision, warmth, and leadership, she keeps the system running flawlessly — and patients safe.

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Sterilization is a hospital’s hidden frontline. In Latin America, 1 in 10 patients gets an infection during their stay (www.ijic.info/article/view...). At the Institute, every instrument is cleaned, tracked, and customized with rigorous care. It’s invisible work — but vital.

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Group of people wearing blue medical scrubs inside the sterilization unit of Colombia's National Cancer Institute --Nubia Prada, the unit's coordinator, is wearing a darker scrub in the middle.

Finding a superhero as an adult isn’t easy — I met one last week.

Visiting Colombia’s National Cancer Institute (www.cancer.gov.c) with the IDB, I joined a team focused on continuous quality improvement. We ended up in the sterilization unit.

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#patientsafety #uhc #qualityofcare #globalhealth

More than 50,000 people die annually in Mexico due to cases of diabetes and kidney disease that could be avoided with "timely and effective healthcare"!

www.thelancet.com/journals/lan...

New work from Castro Vargas, @healthquality.bsky.social, & Bauhoff

Changes and heterogeneity in quality-amenable excess mortality in Mexico: a systematic analysis for the years 2012, 2018, and 2021 Low quality of care has emerged as key policy concern in low and middle-income countries. This study explores the changes and heterogeneity in prevent…

Our findings point to an urgent need for better healthcare quality across Mexico—and more detailed research at the state level to understand where and how to improve.

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www.sciencedirect.com/science/arti...

We also found big differences depending on where people live. For example, Mexico City had much lower death rates from poor care compared to the Center region, which had the highest.

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Both men and women are affected, but the impact differs by condition. Women are more likely to die from poor care when it comes to diabetes, kidney disease, and lung disease. Meanwhile, men tend to die more often because they don’t use healthcare services at all.

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The results are concerning. In 2012, just over half (52.5%) of these preventable deaths were linked to poor quality of care. By 2021, that number had increased to 57.2%.
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Figure explaining how the share poor quality mortality is obtained from the total mortality. First, feasible mortality is calculated from reference countries, which is extracted from total mortality to obtain excess mortality. Then excess mortality is divided into preventable causes, which could have been avoided though public health measures and addressing social determinants of health, and healthcare amenable mortality, which is directly attributable to health care. Finally, healthcare amenable mortality includes mortality due to non-utilization of services and due to poor quality.

We looked at deaths in Mexico in 2012, 2018, and 2021 among people who had access to healthcare but died from conditions that could have been prevented with better-quality care.

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Changes and heterogeneity in quality-amenable excess mortality in Mexico: a systematic analysis for the years 2012, 2018, and 2021 Low quality of care has emerged as key policy concern in low and middle-income countries. This study explores the changes and heterogeneity in prevent…

Check out our paper on deaths due to healthcare quality in Mexico, co-authored with Sofia Castro Vargas and Sebastian Bauhoff, in The Lancet Regional Health – Americas!

www.sciencedirect.com/science/arti...

Some findings in the thread.

#healthquality #healthcare #mexico #qualityimprovement

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9. The concept of "co-producing health" with patients emphasizes the role of communities in improving outcomes.

10. Improvement is a natural process—like a child learning not to touch a flame, health systems should make quality improvement simple and accessible for everyone.

Enjoy the video!

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6. Quality improvement should be embedded into the daily work of health professionals and supported by strong leadership at all levels

7. Improvement is everyone’s job, from frontline workers to policymakers

8. Training, motivation, and a non-punitive culture of learning from mistakes are key

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3. Context matters—different countries and healthcare settings require tailored solutions; no universal formula

4. Collecting data alone does not improve healthcare; acting on insights is crucial

5. Collaboration between all levels of the system is essential for meaningful improvements

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1. Quality care is not a single intervention but a system-wide effort ensuring the right care at the right time

2. Quality care must be patient-centered, effective, responsive, and respectful, combining evidence-based medicine, efficient healthcare systems, and a continuous improvement culture

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YouTube video by Salud Mesoamérica / IREM ISM Sesión 6: Perspectiva sistémica y calidad de atención - un diálogo estratégico

How Can Health Systems Drive #QualityImprovement?

I had the privilege of facilitating a panel on #healthcare quality improvement, as we reflected on the in the successes, challenges, and key lessons of @saludmesoamerica.org.

Ten takeaways...

www.youtube.com/watch?v=oSB7...

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#healthquality

Diego Rios-Zertuche, Jafet Arrieta, Pedro Bernal and Rashad Massoud

Last week, we reflected on a decade of @saludmesoamerica.org successes, challenges, and key lessons.

I had the privilege of facilitating a panel on healthcare quality improvement with Rashad Massoud, Jafet Arrieta, and Pedro Bernal —insightful leaders driving improvement.

Video coming soon!

Una década de esfuerzos para reducir la mortalidad materna y neonatal: la Iniciativa Salud Mesoamérica - Primeros Pasos Durante el verano de 2012, en una visita a la comarca indígena de Guna Yala, en el noreste de Panamá, conocimos a Iranelda, una joven de 16 años que estaba de parto y cuyo bebé estaba en posición tran...

Una década de esfuerzos para reducir la #mortalidad #materna y #neonatal: la Iniciativa #Salud #Mesoamérica

blogs.iadb.org/desarrollo-i...

Our free eBook on Quality of TB Care!

Download 👇🏽

www.mcgill.ca/tb/files/tb/...

Nice example of editorial incentives aligned with academic incentives… and poor metrics to measure success.

Great read! Reminded me of a great paper from C. Olaya: in milk production models, cows aren't always considered—higher milk prices don't make milk producing cows to appear! There's a delay in the system. Similar dynamics apply to immigration...

proceedings.systemdynamics.org/2012/proceed...

@saludmesoamerica.org

Inicio de la medición de la 1a fase en Honduras

⏩ ¡La Iniciativa Regional para la #Eliminación de la #Malaria ( #IREM ) inició la medición de la primera fase para apoyar a la #SESAL de #Honduras a acelerar su progreso hacia la eliminación de la #malaria en el país! ⚕️

Great list! Many of the books are also available as audiobooks!

For the authors: if yours is not yet published as an audiobook, make it happen. Many of us will appreciate it!

Inicio de la medición de resultados de la 1a fase de Guatemala

¿Sabías que Guatemala está trabajando para eliminar la malaria en el país?

¿En que estamos en el camino hacia la eliminación de la malaria en Guatemala? Iniciamos la medición de la primera fase de la Iniciativa para medir los resultados alcanzados y el progreso del país hacia la eliminación de la malaria. Esto nos permite verificar si se han alcanzado las metas comprometidas entre el Ministerio de Salud Pública y Asistencia Social y el BID. Al alcanzar estas metas, Guatemala recibirá un premio al desempeño.

La medición se realiza entrevistando a personas en sus hogares y visitando establecimientos de salud.

⏩ ¡La Iniciativa Regional para la #Eliminación de la #Malaria ( #IREM ) inició la medición de la primera fase para apoyar al #MSPAS de #Guatemala a acelerar su progreso hacia la eliminación de la #malaria en el país! ⚕️

#Salud #SaludGlobal #EliminacionMalaria #Mesomaerica

Inicio de la medición de resultados de la 1a fase en El Salvador

¿Sabías que El Salvador obtuvo la certificación de país libre de malaria de la Organización Mundial de la Salud en el 2021?

¿En qué etapa estamos para asegurar que no vuelva la malaria? Estamos iniciando la medición de la primera fase de la Iniciativa para medir los resultados para prevenir la reintroducción de la malaria en el país. Esto nos permite verificar si se han alcanzado las metas comprometidas entre el Ministerio de Salud y el BID. Al cumplirlas, El Salvador recibirá un premio al desempeño.

La medición se realiza entrevistando a personas en sus hogares y visitando establecimientos de salud.

🚀 ¡La Iniciativa Regional para la #Eliminación de la #Malaria (#IREM) inició la medición de la primera fase para ayudar a prevenir la reintroducción de la malaria en #ElSalvador! 🌿
#Salud #SaludGlobal #EliminacionMalaria