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Selecting topic areas for developing quality standards in a resource-limited setting
  1. Roongnapa Khampang1,
  2. Sarayuth Khuntha1,
  3. Phorntida Hadnorntun1,
  4. Suthasinee Kumluang1,
  5. Thunyarat Anothaisintawee1,2,
  6. Sonvanee Tanuchit1,
  7. Sripen Tantivess1,
  8. Yot Teerawattananon1
  1. 1Health Intervention and Technology Assessment Program, Nonthaburi, Thailand
  2. 2Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  1. Correspondence to Sarayuth Khuntha; sarayuth.k{at}


Variation in practices of and access to health promotion and disease prevention (P&P) across geographical areas have been studied in Thailand as well as other healthcare settings. The implementation of quality standards (QS)—a concise set of evidence-informed quality statements designed to drive and measure priority quality improvements—can be an option to solve the problem. This paper aims to provide an overview of the priority setting process of topic areas for developing QS and describes the criteria used. Topic selection consisted of an iterative process involving several steps and relevant stakeholders. Review of existing documents on the principles and criteria used for prioritising health technology assessment topics were performed. Problems with healthcare services were reviewed, and stakeholder consultation meetings were conducted to discuss current problems and comment on the proposed prioritisation criteria. Topics were then prioritised based on both empirical evidence derived from literature review and stakeholders’ experiences through a deliberative process. Preterm birth, pre-eclampsia and postpartum haemorrhage were selected. The three health problems had significant disease burden; were prevalent among pregnant women in Thailand; led to high mortality and morbidity in mothers and children and caused variation in the practices and service uptake at health facilities. Having agreed-on criteria is one of the important elements of the priority setting process. The criteria should be discussed and refined with various stakeholders. Moreover, key stakeholders, especially the implementers of QS initiative, should be engaged in a constructive way and should be encouraged to actively participate and contribute significantly in the process.

  • quality improvement
  • healthcare quality improvement
  • standards of care
  • primary care

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  • Contributors Khampang collected data, analysed and interpreted the findings and was a major contributor in writing the manuscript. Khuntha and H also collected and analysed data and drafted the manuscript. Kumluang, Anothaisintawee and Tanuchit collected and analysed data. Tantivess and Teerawattananon supervised the overall process of the study and provided feedback and suggestions on the manuscript. All authors read and approved the final manuscript.

  • Funding Financial support for this study was provided entirely by the National Health Security Office (NHSO), Thailand, grant number 60A00744.

  • Disclaimer The findings, interpretations and conclusions expressed in this article do not necessarily reflect the views of the aforementioned funding agencies.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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