About

Sheila Leatherman, CBE, Hon FRCP, is a Professor of Global Health Policy at the UNC Gillings School of Global Public Health, with extensive expertise in health care management, public health, and health policy. Her professional experience encompasses work across over 50 countries in Europe, Africa, Asia, Latin America, and North America, focusing on developing methods to assess health system performance and advising governments on improving quality of care worldwide. She has been recognized for her contributions by being elected to the U.S. National Academy of Sciences in 2002 as a member of the Institute of Medicine, awarded the honor of Commander of the British Empire (CBE) in 2007 for her work in the UK’s National Health Service, and appointed an Honorary Fellow of the Royal College of Physicians (FRCP) in 2008. In 2019, she received the Presidential Distinction Award from the International Society for Quality for her work in low- and medium-income countries. Currently, she serves as a Lead Advisor to the World Health Organization, developing foundational support for national health care quality agendas globally. Her recent research focuses on improving health care in extreme adversity, underpinning publications such as the 2021 WHO report on quality of care in fragile, conflict-affected, and vulnerable settings. She is actively involved in initiatives like the Gillings Humanitarian Health Initiative, which aims to strengthen efforts to improve health outcomes in fragile contexts through education, internships, service projects, and advocacy.

Research topics

• Political Science
• Medicine
• Nursing
• Pathology
• Operations management
• Psychology
• Environmental health
• Economic growth

Selected publications

• Quality of care should be a core consideration in health systems recovery from COVID-19

  UNC Libraries · 2025-06-24

  articleOpen accessSenior author

  Coronavirus disease-2019 (COVID-19) has shocked health systems globally, overwhelming rich and poor countries and highlighting both the need for and risks to quality care. Massive and persistent problems have been encountered in providing public health interventions as well as acute and chronic care for COVID-19 and in maintaining reliable provision of essential health services, already daunting for much of the world in so-called ordinary times. 

  PublisherDOI

• Achieving high-quality universal health coverage: a perspective from the National Health Service in England

  UNC Libraries · 2025-08-29

  articleOpen access

  Governments across low-income and middle-income countries have pledged to achieve universal health coverage by 2030, which comes at a time where healthcare systems are subjected to multiple and persistent pressures, such as poor access to care services and insufficient medical supplies. While the political willingness to provide universal health coverage is a step into the right direction, the benefits of it will depend on the quality of healthcare services provided. In this <em>analysis paper</em>, we ask whether there are any lessons that could be learnt from the English National Health Service, a healthcare system that has been providing comprehensive and high-quality universal health coverage for over 70 years. The key areas identified relate to the development of a coherent strategy to improve quality, to boost public health as a measure to reduce disease burden, to adopt evidence-based priority setting methods that ensure efficient spending of financial resources, to introduce an independent way of inspecting and regulating providers, and to allow for task-shifting, specifically in regions where staff retention is low.

  PublisherDOI

• Assessing the feasibility of using publicly available data sources to identify healthcare data discrepancies and enhance service delivery: a retrospective cross-sectional study of four low human index scoring countries

  UNC Libraries · 2025-03-08

  articleOpen access

  Introduction Quality of care (QoC) remains a persistent challenge in countries with low Human Development Index scores (LHDIS) despite global efforts to promote universal health coverage. Addressing root causes and systematically implementing improvement interventions in LHDIS countries require a better understanding and use of QoC data. We aim to describe the data gaps and illustrate the state of quality in health services across a small set of countries. We demonstrate how we can leverage currently available, although imperfect, public data sources to compile quality metrics across multiple LHDIS countries. Methods Using public data sources, the Demographic Health Survey (DHS) and Service Provision Assessment (SPA), we selected relevant quality metrics and categorised them within a QoC matrix. We based the selection of metrics on the quality of care in fragile, conflict-affected and vulnerable settings framework domains and the Donabedian model. Criteria for our retrospective cross-sectional study included a LHDIS and recent availability of both DHS and SPA data for data relevance. Results The approach was feasible, with relevant indicators distributed across various QoC categories. However, some cells in the indicator matrix lacked suitable indicators from SPA and DHS data. We selected the Democratic Republic of the Congo, Haiti, Afghanistan and Senegal for a snapshot of QoC in LHDIS countries. Comparisons highlighted areas of positive performance and shared challenges across these countries, with notable variability in certain categories. Senegal ranked highest overall, while Afghanistan ranked lowest across all matrix categories. Senegal had the most comprehensive data, with 94.7% of metrics available. Missing data existed for two specific metrics in all four countries, particularly within the improving clinical care domain. Conclusion The results are a clarion call for advancing efforts to develop standardised, publicly available, routinely collected and validated data sets to measure and publicly report LHDIS countries’ state of quality to marshal global attention and action in pursuit of more significant health equity.

  PublisherDOI

• Addressing the consequences of conflict in Sudan

  The Lancet · 2025-11-01

  articleSenior author
  PublisherDOI

• Assessing the feasibility of using publicly available data sources to identify healthcare data discrepancies and enhance service delivery: a retrospective cross-sectional study of four low human index scoring countries

  BMJ Public Health · 2024-05-01 · 1 citations

  articleOpen accessSenior author

  Introduction: Quality of care (QoC) remains a persistent challenge in countries with low Human Development Index scores (LHDIS) despite global efforts to promote universal health coverage. Addressing root causes and systematically implementing improvement interventions in LHDIS countries require a better understanding and use of QoC data. We aim to describe the data gaps and illustrate the state of quality in health services across a small set of countries. We demonstrate how we can leverage currently available, although imperfect, public data sources to compile quality metrics across multiple LHDIS countries. Methods: Using public data sources, the Demographic Health Survey (DHS) and Service Provision Assessment (SPA), we selected relevant quality metrics and categorised them within a QoC matrix. We based the selection of metrics on the quality of care in fragile, conflict-affected and vulnerable settings framework domains and the Donabedian model. Criteria for our retrospective cross-sectional study included a LHDIS and recent availability of both DHS and SPA data for data relevance. Results: The approach was feasible, with relevant indicators distributed across various QoC categories. However, some cells in the indicator matrix lacked suitable indicators from SPA and DHS data. We selected the Democratic Republic of the Congo, Haiti, Afghanistan and Senegal for a snapshot of QoC in LHDIS countries. Comparisons highlighted areas of positive performance and shared challenges across these countries, with notable variability in certain categories. Senegal ranked highest overall, while Afghanistan ranked lowest across all matrix categories. Senegal had the most comprehensive data, with 94.7% of metrics available. Missing data existed for two specific metrics in all four countries, particularly within the improving clinical care domain. Conclusion: The results are a clarion call for advancing efforts to develop standardised, publicly available, routinely collected and validated data sets to measure and publicly report LHDIS countries' state of quality to marshal global attention and action in pursuit of more significant health equity.

  PublisherOA PDFDOI

• Safeguarding quality of care in active conflict: priority issues and interventions in Sudan

  International Journal for Quality in Health Care · 2024-12-19 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• Barriers to mental healthcare in the Kurdistan region of Iraq: practitioner perspectives

  Medicine Conflict & Survival · 2024-12-16 · 2 citations

  article
  PublisherDOI

• Vijana Vijiweni II : A cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intima

  Figshare · 2023-01-01

  article

  Article published in: BMC Public Health (2016) 16:113.

  DOI

• Advancing quality in low human development index scoring countries; the need for standardized and shared quality measurement and reporting

  International Journal for Quality in Health Care · 2023-07-01

  articleOpen access1st authorCorresponding

  Over the past decade, significant research and documentation have emphasized the global importance of assessing and enhancing quality health services in low human development index scoring (LHDIS) countries [1–3]. This endeavor requires continuous monitoring, evaluation, and accessible measurement of systematic quality of care (QoC), requiring collaborative efforts within and between nations. The Organization for Economic Co-operation and Development (OECD) member countries have successfully demonstrated the feasibility of such initiatives to collect and report quality data [4]. However, the OECD Health Care Quality Initiative, a pivotal tool shaping health-care policies, exclusively benefits high-performing and data-rich economies among its current 38 member nations, posing challenges for other less-resourced economies [4]. Health care is widely recognized as a fundamental human right. It is therefore imperative to intensify efforts to improve the basic information necessary for effectively delivering health services as a public good in all settings. Collective action is needed to support LHDIS countries to develop similar health-care data and information infrastructure capabilities to OECD member countries, leveraging existing health system measurement initiatives...

  PublisherOA PDFDOI

• Safety in fragile, conflict-affected, and vulnerable settings: An evidence scanning approach for identifying patient safety interventions

  Journal of Global Health · 2022 · 4 citations

  • Political Science
  • Medicine
  • Nursing

  Background: The number of people living in fragile, conflict-affected, and vulnerable (FCV) settings is growing rapidly and attention to achieving universal health coverage must be accompanied by sufficient focus on the safety of care for universal access to be meaningful. Healthcare workers in these settings are working under extreme conditions, often with insufficient contextualized evidence to support decision-making. Recognising the relative paucity of, and methodological issues in gathering evidence from these settings, the evidence scanning described in this paper considered which patient safety interventions might offer the 'better bet', eg, the most effective and appropriate intervention in FCV settings. Methods: An evidence scanning approach was used to examine the literature. The search was limited to FCV settings and low-income settings as defined by the World Bank, but if a systematic review included a mix of evidence from FCV/low income settings, as well as low-middle income settings, it was included. The search was conducted in English and limited to studies published from 2003 onwards, utilising Google Scholar as a publicly accessible database and further review of the grey literature, with specific attention to the outputs of non-governmental organisations. The search and subsequent analysis were completed between April and June 2020. Results: The majority of studies identified related to strengthening infection prevention and control which was also found to be the 'better bet' intervention that could generalise to other settings, be most feasible to implement, and most effective for improving patient care and associated outcomes. Other prioritized interventions include risk management, with contributing elements such as reporting, audits, and death review processes. Conclusions: Infection prevention and control interventions dominate in the literature for multiple reasons including strength of evidence, acceptability, feasibility, and impact on patient and health worker well-being. However, there is an urgent need to further develop the evidence base, specialist knowledge, and field guidance on a range of other patient safety interventions such as education and training, patient identification, subject specific safety actions, and risk management.

  PublisherOA PDFDOI

Frequent coauthors

• Kim Sutherland

  Government of New South Wales

  14 shared

• Martin Marshall

  University College London

  11 shared

• Kelsey Flott

  Imperial College London

  8 shared

• Alexandra Shaw

  University of Edinburgh

  8 shared

• Ana Luísa Neves

  Imperial College London

  8 shared

• Robert H. Brook

  8 shared

• Valerie L. Flax

  RTI International

  7 shared

• Paul G Shekelle

  VA Greater Los Angeles Healthcare System

  7 shared

Awards & honors

• Commander of the British Empire (CBE)
• Honorary Fellow of the Royal College of Physicians (FRCP)
• Presidential Distinction Award of the International Society…
• appointed to the Polio Transition Independent Monitoring Boa…