Dr. Sylvia Sax is an international public health consultant, researcher and lecturer at the Institute of Public Health, University of Heidelberg, Germany. Her areas of expertise include healthcare quality management, healthcare accreditation, health system strengthening, health provider motivation, and results based financing. Sylvia works with governments and organisations throughout the world such as in Kenya, Tanzania, Cambodia, Kazakhstan, Pakistan, Yemen and India. Sylvia holds a doctoral degree from the University of Heidelberg, a Master in Public health from Otago University in New Zealand and a B.Sc. in Nursing from the University of Illinois, Chicago, USA. She is a Fellow of Session 489 Making Health Care Better in Low and Middle Income Economies: What are the next steps and how do we get there?