Service Quality and Evaluation
of the Campaign in various localities demands health-care solutions to the problem of headache as it exists locally. These solutions will generally depend upon the planning and implementation of new headache services or upon improvement of those that currently exist, in either case seeking to achieve the best possible.
There are two key questions.
1. How is "quality" defined in the context of headache services, and from whose perspective(s):
a) people with headache?
b) health-care providers?
c) the general population?
d) society?
2. In the light of a definition of quality, how, methodologically, should headache services be evaluated?
There is no agreement on the meaning of "best" in this context. Consequently, there is no established methodology for evaluating headache services and no agreed standard against which to evaluate them. If effectiveness and cost-effectiveness are important, headache services (as opposed to specific treatments that services might deliver) have never been demonstrated to achieve either.
Following a worldwide process of consultation on these questions, Lifting The Burden is developing both a definition of "quality" and a set of quality indicators coupled with methods to apply them. These will be published soon.