Scaling up and institutionalizing continuous quality improvement in the free maternity and child care program in Ecuador

The present document reports on an operations research study conducted by the Quality Assurance Project (QAP) to examine the process of institutionalizing a Continuous Quality Improvement (CQI) process within the context of the reforms introduced by the Law for the Provision of Free Maternity Services and Child Care. The objectives of the study were: a) Describe and document the process, methods, and results of scaling-up and institutionalizing a quality assurance mechanism within the Free Maternity Program of the Ministry of Health of Ecuador; b) Explore associations between the degree of institutionalization achieved and the presence of reforms introduced by the Law, believed to be favorable to the QA institutionalization process; and c) Synthesize lessons learned that can be adapted and applied in other Latin American countries. The main research questions of the study were: a) Is it possible to achieve expansion of CQI through a decentralized intervention involving staff from provincial offices of the MOH (CQI facilitators), who replicate training sessions and locally support and monitor the work of quality improvement teams?; b) Which are the main factors that facilitate or constrain the application of the CQI model?; c) What is the model's cost?; d) What are the results in terms of the extent of CQI expansion and quality improvement of healthcare? (excerpt)

Report Author(s): 
Hermida J | Robalino ME | Vaca L | Ayabaca P | Romero P
Latin America and Caribbean Regional Health Sector Reform Initiative
ASSIST publication: 
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