Abstract

SMITH, Sarah C  and  HURTADO, Elena. Improving the Quality of Maternal and Neonatal Services in Guatemala. Rev. costarric. salud pública [online]. 2014, vol.23, n.1, pp.63-67. ISSN 1409-1429.

Objective The ProCONE strategy was designed to improve the quality of services for women and newborns in Guatemala utilizing a collaborative improvement process. This case study aimed at understanding the process of spreading ProCONE from a district health center to health units at the primary level of care in one district in Guatemala. Methodology The principal investigator spent one week in August 2011 visiting health facilities and conducting semi-structured interviews with health staff. Iterative thematic analysis was performed. Findings The process of spreading ProCONE began with the head of the district health center, which introduced the strategy and trained the nurses at the primary level of the health system. Interviewees referred to two successful practices - standardization of clinical records and home visits to pregnant and post-partum women and their newborns to provide care or referral. Health personnel began using indicators to measure change. All facilities had time series charts in the waiting rooms. One nurse commented that it was difficult to implement the home visits due to distance and lack of gasoline. All the interviewees believed that ProCONE provided an integrated system for improving the quality of care. Conclusions Elements of ProCONE were transferred from the district health center to other facilities. However, limited understanding of how data could direct the provision of services suggested that the capacity to improve was not spread, even if best practices were successfully spread. To develop capacity, it is necessary to involve health staff in the search for solutions appropriate to the challenges.

Keywords : Quality Improvement; Maternal Welfare; Guatemala.

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