Health sector reform efforts in the Latin America and Caribbean (LAC) region have, in recent years, focused on strengthening the stewardship role of the public sector in regulating healthcare and assuring the quality of health services. Through regulatory approaches, governments establish expectations for the competence of healthcare providers and institutions and for the quality of services these provide. This paper was commissioned to examine experiences in the region with the regulation of the quality of care of healthcare providers and facilities, to derive lessons and implications for future policy development, programming, and research. The research was carried out through literature review and interviews with key informants. While this research is certainly not exhaustive of this extensive subject area, it aims to provide insights into the challenges facing current initiatives in healthcare quality regulation and provide direction for the future. Three main approaches to quality regulation have been used by governments and professional bodies to ensure, maintain, and improve the quality of healthcare: licensing, certification, and accreditation. The three approaches are not mutually exclusive—each has a distinct purpose and can contribute to a country’s overall strategy for ensuring quality of healthcare services—and indeed are complementary. All three approaches are based on evaluation of adherence to explicitly defined standards and strive to create uniformity of practice by service providers and delivery systems. The three approaches also differ in important ways: whether they are mandatory or voluntary; in the nature of the issuing or enforcing organization; with respect to what entity is the object of evaluation; in the level of detail of requirements and the scope of the standards; in the frequency with which evaluation in carried out; and in the assessment methodology used. (excerpt)