Implementation and progress of an inclusive primary health care model in Guatemala: coverage, quality, and utilization Ejecución y avance de un modelo inclusivo de atención primaria de salud en Guatemala: cobertura, calidad y utilización

• Main Authors: Meredith P Fort, David E Grembowski, Juan C Verdugo, Lidia C Morales, Carmen A Arriaga, Mary A Mercer, Stephen S Lim
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2011
• Subjects: Atención primaria de salud; evaluación de programas y proyectos de salud; evaluación de servicios de salud; Guatemala; Primary health care; program evaluation; health services evaluation; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; San Juan
• Online Access: https://doaj.org/article/fead5629e5e2415bb9bcaf07960e4d3e

OBJECTIVE: To describe a primary health care model designed specifically for Guatemala that has been implemented in two demonstration sites since 2004 and present results of a process evaluation of utilization, service coverage, and quality of care from 2005 to 2009. METHODS: Coverage, utilization, and quality were assessed by using an automated database linking census and clinical records and were reported over time. Key maternal and child health coverage measures were compared with national-level measures. RESULTS: The postnatal coverage achieved by the Modelo Incluyente de Salud of nearly 100.0% at both sites contrasts with the national average of 25.6%. Vaccination coverage for children aged 12-23 months in the Modelo Incluyente de Salud reached 95.6% at site 1 (Bocacosta, Sololá) and 92.7% at site 2 (San Juan Ostuncalco), compared with the national average of 71.2%. Adherence to national treatment guidelines increased significantly at both sites with a marked increase between 2006 and 2007. Utilization increased significantly at both sites, with only 7.5% of families at site 1 and 11.2% of families at site 2 not using services by the end of the 5-year period. CONCLUSIONS: Coverage, quality of care, and utilization measures increased significantly during the 5-year period when the service delivery model was implemented. This finding suggests a strong possibility that the model may have a benefit for health outcomes as well as for process measures. The Modelo Incluyente de Salud will be financially sustained by the Ministry of Health and extended to at least three additional sites. The model provides important lessons for primary care programs internationally. OBJETIVO: Describir un modelo de atención primaria de salud diseñado específicamente para Guatemala que se ha ejecutado en dos sitios piloto desde 2004 y presentar los resultados de una evaluación de la utilización, la cobertura de servicios y la calidad de la atención entre 2005 y 2009. MÉTODOS: Se evaluaron la cobertura, la utilización y la calidad ...