A detailed standards-based performance approach modestly improved providers' performance and facility readiness to offer antiretroviral therapy. The approach included mutually reinforcing activities: (1) training, (2) supportive supervision, (3) assessments of service quality, and (4) facility-based action plans.
Our findings show that the CQI program in maternal and perinatal health services was positively associated with US. These results reinforce the need for cordiality during prenatal care contacts with providers, and the need to provide appropriate information to the user, in order to help increase acceptability of and adhesion to health care recommendations among pregnant women.
La mortalidad materna es uno de los indicadores sanitarios que con más fidelidad expresa la iniquidad y la exclusión social. Más de medio millón de muertes maternas se producen anualmente en el mundo. El 99% sucede en los países en desarrollo. Vivir en condiciones de pobreza limita a las mujeres el acceso a los recursos económicos, sociales y a la educación básica. De ese modo, disminuye su capacidad de tomar decisiones informadas en salud y nutrición. La mortalidad materna expresa, además, la iniquidad de género para la toma de decisiones, para los derechos fundamentales y los servicios sociales.
Since 1984, in Latin America donor agencies and national governments have extensively supported the implementation of the Community Oral Rehydration Units (CORUs) in an attempt to increase the access to oral rehydration therapy and improve the case management of diarrhoea at the community level. This study surveyed 40 CORUs in two regions of Peru to assess their operation, the number of patients with diarrhoea attended, and the knowledge of volunteers in charge. The results show that CORUs were mainly implemented close to existing health centres; the median of case load was 2.0 patients in the preceding month; and the volunteers' knowledge of case management was principally deficient in the diagnosis of hydration status, dietary management and in preventive measures. This lack of knowledge was replicated by professionals at the supervising health centres. Despite the fact that CORUs have been functioning for around four years, they exhibit numerous deficiencies which prevent them from fulfilling their objectives. A global review of the whole CORU strategy is called for.
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