1. Strengthening quality assurance system in hospital management Yuriy Azamatov Medical Accreditation Commission Bishkek - 2015

2. Key measures on the regional level: Kyrgyzstan and Tajikistan 1.Development of accreditation standards for maternity departments 2.Revision of accreditation standards for hospitals 3.Revision and adaptation of legislative and normative base of accreditation system (regulation and guidelines) 4.Assessment of new standards by testing, discussions, feedback and technical clearance 5.Training for accreditation experts and health facilities on newly developed standards and procedures 6.Certification of accreditation standards at International Society on Quality in healthcare (ISQua) 7.Introduction of accreditation standards into practice (accreditation of health facilities against new standards)

4. Results (1) 1.Accreditation standards for maternities based on effective, EBM practices and WHO quality improvement tools and standards 2.Accreditation standards for hospitals with more focus to quality 3.Recommendations on improving of accreditation system and accreditation body 4.Training provision at the national level: for health facilities -15 trainings (218 participants); for experts - 5 trainings (69 participants); in Tajikistan - 18 experts (practical skills gained during the exchange visits to Kyrgyzstan) 5.Training provision in Tajikistan: for health facilities – 5 trainings (107 participants); for experts - 4 trainings (61 participants); 6.Certification of accreditation standards for hospitals by ISQua, in Kyrgyzstan (2014), Tajikistan (2015)

5. Results (2) 6.Since 2014, 5 health facilitates were accredited by new accreditation standards 7.Since 2013, 41 hospitals accredited by new standards (total coverage is 51,3% health facilitates with maternity department): 29 health facilitates (70,7%) confirmed their category ; 10 health facilitates (24,4%) got the lower category  ; 2 health facilities (4,9%) got the higher category 9.Introduction of new standards contributed to: objectification of accreditation results; problems analysis and solutions for quality improvement (strategic panning, investments in capacity building of HR, risks management, safe drug management, application of clinical protocols and guidelines, efficient resource utilization, safety maintenance, etc.)

6. Accreditation of standards in ISQua 6 th version of standards for hospitals were certified in 2014 by ISQua according to the 3 rd Edition of principles for healthcare standards

7. Challenges 1.No incentives and low motivation for accredited health facilities; 2.Insufficient support and lobbying of accreditation tool at policy level (the results of accreditation are not used properly for decision making, improvement and encouraging); 3.Low awareness of local authorities and population on benefits of accreditation; 4.Financial instability (organizational development of MAC and assessors, costs for accreditation);

8. 1.Development and introduction the system of incentives and motivation for health facilities to pass accreditation; 2.Promoting of accreditation at political level and ensuring the financial stability; 3.Raising awareness on accreditation (feedback from health facilities) and using information technologies (web-site); 4.Propore utilization of accreditation results in quality improvement (system level, facility level); 5.Cooperation development with patients rights and civil society organizations; 6.Further development of regional and international cooperation; Opportunities for development: