Patient safety and quality of care in developing countries in Southeast Asia: a systematic literature review

Int J Qual Health Care. 2015 Aug;27(4):240-54. doi: 10.1093/intqhc/mzv041. Epub 2015 Jun 12.


Objective: To establish current knowledge of patient safety and quality of care in developing countries in Southeast Asia, current interventions and the knowledge gaps.

Study design: Systematic review and narrative synthesis.

Data sources: Key words, synonyms and subject headings were used to search seven electronic databases in addition to manual searching of relevant journals.

Data synthesis: Titles and abstracts of publications between 1990 and 2014 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesized.

Results: Four inter-related safety and quality concerns were evident from 33 publications: (i) the risk of patient infection in healthcare delivery, (ii) medications errors/use, (iii) the quality and provision of maternal and perinatal care and (iv) the quality of healthcare provision overall.

Conclusions: Large-scale prevalence studies are needed to identify the full range of safety and quality problems in developing countries in Southeast Asia. Sharing lessons learnt from extensive quality and safety work conducted in industrialized nations may contribute to significant improvements. Yet the applicability of interventions utilized in developed countries to the political and social context in this region must be considered. Strategies to facilitate the collection of robust safety and quality data in the context of limited resources and the local context in each country are needed.

Keywords: patient safety, developing countries; patient safety, incident reporting and analysis; patient safety, medical errors; quality culture; quality management, adverse events; specific populations.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Asia, Southeastern / epidemiology
  • Cross Infection / epidemiology
  • Developing Countries*
  • Humans
  • Maternal Health Services / standards
  • Medication Errors / statistics & numerical data
  • Patient Safety*
  • Perinatal Care / standards
  • Quality of Health Care*