Norms and standards for quality

Norms and standards help to establish the safety, reliability and quality of services. You will have noted by now that quality is not an absolute concept, but can be measured against the performance of other groups or against what is expected, i.e. a standard or norm.

A standard is a specification of characteristics which is used as a tool to consistently assess quality. Standards are usually developed from an evidence-base by a committee or panel of experts and by building consensus across different groups. Norms tend to reflect trends and can change where standards tend to be fixed.

In the following section we will:

  • Revisit some approaches to capturing quality.
  • Look at how norms and standards can be used for auditing and performance management processes.

The UN Emergency obstetric and newborn care signal functions

The most established norms in Maternal and Newborn Health (MNH) are the UN process indicators and signal functions (see Section C) relating to emergency obstetric and newborn care (EmONC). As noted earlier, these form part of the UN/WHO guidelines on EmONC and continue to provide a benchmark in MNH. These indicators are used in many settings and as part of needs assessment, service design and service monitoring processes.

In addition to generating the indicators on emergency care as discussed earlier some ‘norms’ have been defined as recommended minimum and maximum levels. The following table provides a overview of the recommended ‘norms’ for the process indicators.

Emergency obstetric care: United Nations process indicators and recommended levelsFigure 4.2. Emergency obstetric care: United Nations process indicators and recommended levels
Question for reflection: What are the challenges facing the health system in achieving and maintaining the signal functions defined by WHO as the minimum standard for delivery of EmONC services?
Norms and standards for quality was last modified: June 18th, 2015 by Adrian Bannister