RESUMO
There is a widespread interest in strengthening the quality agenda in low- and middle-income countries, but the optimal strategies for achieving this are not well defined. We offer an appraisal of the health challenges these countries are confronting, the resources and services provided by their health systems and the spectrum of options between policy and practice. Global health context section presents a brief discussion of the global health context. A descriptive picture of health and health care in LMIC section discusses the specific health conditions and the health-care environment in developing nations, using traditional health and health services indicators as reference points. Questions to consider for strengthening the quality improvement agenda in low and middle-income countries section sets forth key questions that quality improvement professionals should consider in the design of a quality agenda for low- and middle-income countries.