How Licensing and Accreditation Shape Health Care in Developing Nations

The researchers wanted to see how rules and accreditation affect health workers and care quality in low‑ and middle‑income countries. They followed PRISMA 2020 guidelines and searched several databases. Studies from 2010 to early 2026 were included. Only sources that looked at regulation or accreditation in at least one LMIC made the cut.

Thirty‑five sources made the final list. Most came from the Middle East and North Africa, especially Iran. Others were from sub‑Saharan Africa, East and South Asia, and a single study from Latin America. Twelve of the sources covered more than one country. The bulk of the work examined accreditation of health facilities. Very few looked at medical education or the licensing of individual doctors.

The evidence focused on how institutions operate. Accreditation was linked to standard procedures, paperwork, internal quality checks, and governance. Only three studies measured workforce results, and the findings were mixed. Two impact evaluations gave different pictures of clinical quality, leaving the overall picture unclear.

The review used policy analysis tools to understand why systems differ. It applied Walt and Gilson’s Policy Triangle and two theoretical lenses. The authors conclude that while accreditation can improve processes, its effect on actual patient care is still uncertain. More research is needed, especially on how regulation and accreditation influence the people who deliver care.