• Nurul A Sidik, Lilliana Lazuardi, Fransisca H Agung, Kirana Pritasari, Hanny Roespandi, Tini Setiawan, Udjiani Pawitro, Waldi Nurhamzah, Martin W Weber, and Indonesian Paediatric Hospital Assessment Group.
• Indonesian Commission for Hospital Accreditation, Jakarta, Indonesia.
• Trop. Med. Int. Health. 2013 Apr 1;18(4):407-15.

ObjectivesTo obtain an overview of the quality of care for children in Indonesia, by assessing hospitals with a view to proceed to a quality improvement mechanism for child care.MethodsStratified two-stage random sampling in six regions identified 18 hospitals (provinces Jambi, East Java, Central Kalimantan, South-East Sulawesi, East Nusa Tenggara, North Maluku). Three randomly selected hospitals in each province were visited by trained assessors who scored each assessed service (expressed as a percentage of achievement) and grouped into good (≥ 80%), requiring improvement (60-79%) and urgently requiring improvement (< 60%).ResultsThe overall median result score across all areas was 43% (IQR 28%-53%). Case management for common childhood illnesses had a median score of 37% (IQR18-43%), neonatal care 46% (IQR 26-57%) and patient monitoring 40% (IQR 30-50%), all indicating an urgent need for improvement. Qualitative data showed as main problems inadequate use of standard treatment guidelines, irrational prescribing of antibiotics, poor progress monitoring and poor supportive care.ConclusionWe found serious shortcomings in the quality of hospital care for children. Finding and documenting those is the first step in a quality improvement process. Work is needed to start an improvement cycle for hospital care.© 2013 Blackwell Publishing Ltd. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

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