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• W2080375723 abstract "Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems.The PRICOR Project developed extensive lists of essential tasks and activities for the effective delivery of child survival interventions (PRICOR Thesaurus): case management of acute respiratory infection, malaria, and diarrhea; growth monitoring and promotion; maternal health; and child spacing. It later helped managers and researchers in the use of the Thesaurus to conduct comprehensive systems analyses of these interventions in Colombia, Costa Rica, Haiti, Niger, Indonesia, Pakistan, Peru, Philippine,s Senegal, Togo, Thailand, and Zaire. These analyses confirmed that researchers and program managers can indeed study service delivery through systematic review of health worker performance. Further this evaluation of primary health care (PHC) systems in 12 countries identified repeat program deficiencies. For example, counseling by health workers to clients was consistently weak. The tended to not explain to mothers proper home treatment, describe danger sings, or ask them to repeat instructions to assure that mothers understood them. Further health workers did not necessarily tell mothers during treatment about their child's nutritional status, type of vaccine being administered, of why they prescribed oral rehydration therapy. This lack of client education is especially significant since, in PHC, the health workers and the caregiver should be partners in achieving successful results. Deficiencies also existed with supervision. For instance, supervisors did not always monitor health workers, rectify errors, or solve problems. Further researchers compare supervisors' perceptions of health worker performance with actual performance. Supervisors tended to overstate performance. Nevertheless these analyses did identify practical solutions to many program deficiencies. In fact, most solutions did not depend on resources availability, PRICOR techniques to design and implement strategies for sustained improvement in PHC in developing countries." @default.
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• W2080375723 date "1991-09-01" @default.
• W2080375723 modified "2023-10-18" @default.
• W2080375723 title "THE QUALITY ASSURANCE PROJECT: INTRODUCING QUALITY IMPROVEMENT TO PRIMARY HEALTH CARE IN LESS DEVELOPED COUNTRIES" @default.
• W2080375723 doi "https://doi.org/10.1093/intqhc/3.3.147" @default.
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