Quality Assurance Policy in Harm Reduction Services in the Czech Republic: A Case Study of a National System

BACKGROUND: In the field of harm reduction (HR), an established quality assurance system with implemented quality standards is rather rare in practice. Together with limited evidence in this area, this leads to an imbalance in the basic segments of drug demand reduction and their lack of compatibility and alignment in terms of therapeutic continuity.

AIMS: The paper presents case study analysis of the context and a description of the original quality management system in harm reduction at the national level.

METHODS: The case study design is based on a narrative review from a search of databases, including grey literature for the period from 1990 to 2022, followed by subsequent qualitative content analysis.

RESULTS: After 1989, there was an exponential increase in HR services, with a strong initiative of non-governmental organisations (NGOs) and significant professionalisation from the beginning of the HR services network. It is the NGO initiative that has contributed significantly to the introduction of a certification and quality standards since 1995. In the following period, the system was expanded to include other quality management components (system for monitoring, ethical standards).

CONCLUSIONS: In terms of national drug policy and the continuous development of drug services, the introduction of a quality assurance system was a critical point with dozens of implications, including balancing and equalising the position of harm reduction in the drug demand reduction system in the Czech Republic.