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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

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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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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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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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!

5/5

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

2/5

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...