Shushufindi General Hospital at the Forefront of Quality Zika Care in Sucumbios, Ecuador

Team members of the three collaboratives executed with the assistance of the ASSIST- Zika Project working on the continuous improvement of quality Zika health care at Shushufindi General Hospital.

“ASSIST’s technical assistance has enabled us to implement substantial changes for the continuous improvement of quality of health care to deal with the Zika epidemic--changes which we hope will be long-lasting--while also strengthening institutional articulation across different resolution levels of the province of Sucumbios.” noted Paulina Guerrero, Quality Analyst, Shushufindi General Hospital.

USAID’s ASSIST Project has provided technical support to Shushufindi General Hospital in the province of Sucumbíos, Ecuador since June 2018 in order to improve the quality of health care for women of reproductive age, newborns and children with microcephaly and congenital syndrome associated with Zika.

“Before receiving technical support from the project, activities such as closely looking out for and examining clinical signs and symptoms of the Zika virus or providing Zika counseling based on quality standards, were not done systematically or were incomplete and of poor quality”, indicated Dr. Marilu Angulo, gynecologist at Shushufindi General Hospital. Similarly, Dr. Rodolfo Vila del Prado, a Cuban pediatrician practicing at this hospital indicates that the technical assistance has strengthened the continuous improvement of the quality of care, with an emphasis on the surveillance and testing of microencephaly in newborns. It has been possible to hone health providers’ ability to identify and diagnose microencephaly in newborns, guaranteeing that they receive quality health care, while simultaneously optimizing resources for the different levels of the province’s healthcare network due to these implemented actions. 

Continuous improvement of health care quality in regard to Zika has won the involvement of all health care professionals, not just formal and capable providers, but also technicians and hospital such as administrative personnel and various at home services provided, all with the goal of achieving excellence across the various services provided.

The continuous improvement methodology implemented in June 2018 at Shushufindi General Hospital is based on the strengthening of the existing continuous quality improvement teams, while also forming collaborative teams for pre-natal care, newborn care, attention and support components.

“We have tried to team up different health care professionals such as nurses, doctors and obstetricians in these collaboratives. With this diverse level of expertise, we can promote collaborative team activities; furthermore, thanks to the different perspectives offered by each professional, we can find solutions to common issues, make headway in untangling critical knots and develop a quality health care policy across all hospital services”, expressed Paulina Guerrero, member of the quality improvement team.

Considerable resistance to change combined with the differing personalities and temperaments complicated the launch of the change strategies. However, permanent awareness, continuous work, the ASSIST Project’s technical assistance, the facilitator’s close involvement, continuous technical/scientific capabilities, the implementation of work aids and care guides have all helped to minimize resistance and to obtain the brilliant results we humbly exhibit today:  all our quality measures are currently at over 90% of compliance.


USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project/URC
ASSIST publication: 
ASSIST publication
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