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This is of growing relevance considering that due to deficiencies in health systems, the main countries affected by Ebola virus disease (EVD) outbreak in West Africa (2014\u20132016) were insufficiently prepared for the epidemic, and according to the WHO, epidemics are increasingly becoming a threat to global health. Our objective is to analyze QI constraints in health systems during that EVD epidemic and to propose a practical framework for QI in health systems for epidemics in developing countries. We applied a framework analysis using experiences shared at the \u201cSecond International Quality Forum\u201d organized by the University of Heidelberg and partners in July 2015 and information gathered from a systematic literature review. Empirical results revealed multiple deficiencies in the health systems. We systemized these shortfalls as well as the QI measures taken as a response during the epidemic. On the basis of these findings, we identified six specific \u201cpriority intervention areas,\u201d which ultimately resulted in the synthesis of a practical QI framework. We deem that this framework that integrates the priority intervention areas with the WHO building blocks is suitable to improve, monitor, and evaluate health system performance in epidemic contexts in developing countries.<\/jats:p>","DOI":"10.1002\/hpm.2814","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T17:46:27Z","timestamp":1558633587000},"page":"52-67","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Quality improvement of health systems in an epidemic context: A framework based on lessons from the Ebola virus disease outbreak in West Africa"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5708-7301","authenticated-orcid":false,"given":"Lucia","family":"Brugnara","sequence":"first","affiliation":[{"name":"Heidelberg Institute of Global Health University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Pervilhac","sequence":"additional","affiliation":[{"name":"Institute of Global Health University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Kohler","sequence":"additional","affiliation":[{"name":"NGO Les Enfants de l'A\u00efr, et Facult\u00e9 de M\u00e9decine de l'Universit\u00e9 de Lorraine  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Lamine","family":"Dram\u00e9","sequence":"additional","affiliation":[{"name":"Success-in-Africa, Think Tank based at the Faculty of Medicine, University of Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Sax","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Marx","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health and evaplan at the University Hospital Heidelberg University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzq028"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzw039"},{"key":"e_1_2_11_4_1","unstructured":"World Health Organization.Health and human rights. 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