Table 3.

Key questions required for learning about quality of care within the health system

	Facility level	District level	National level
Internal learning (eg, within a facility, within a district, within a nation)	What activities did we conduct? How did we conduct them? What was the effect on patient care?	What support did we provide to facilities? What activities did we use to provide this support? How did these activities change provider behaviour and patient care?	What support did we provide to districts and facilities? What activities did we use to provide this support? How did these activities change district or provider behaviour and patient care?
Horizontal learning (eg, learning across facility to facility, learning across district to district)	What did other facilities do to improve care?	What did other districts do to support facilities to improve care?	What did other countries do to support districts and facilities to improve care?
Vertical learning (eg, learning between facility and district, learning between district and national)	How effective was the guidance and support from the district? What other guidance and support is required from the district?	How effective was the guidance and support from the national level? What other guidance and support is required from the national level? What have we learnt that can support other facilities to improve care?	How effective was the guidance and support from the global level? What other guidance and support is required? What have we learnt that can support other districts to improve care?