In 1998, QAP initiated work in the improvement of vaccination rates in the Guatemalan highlands. Representatives from three regions, Sololá, San Marcos, and Chimaltenango were invited to participate in a three-day workshop to learn problem-solving methodology and form action plans to resolve the identified problems. These multi-disciplinary teams consisted of physicians, nurses and technicians from local health centers and posts and in some teams, district leaders and community members. The goal of the Ministry of Health was 80% vaccination coverage. In addition, a community team was aware of the culture as well as the client and community perspectives related to vaccinations. The teams used a fish-bone diagram to describe the causes for the decreased rates. Based on this discussion, the teams prioritized the root causes and developed solutions to address the performance gap. Each team left the workshop with an action plan for implementing their interventions.
The trends in immunization coverage from 1998 to 1999 show mixed improvements. While one team achieved a 30 percent increase in vaccination rates, other teams encountered resistance among leaders and colleagues that delayed the success of their plans. The most important changes were seen in increases in measles coverage from 1998 to 1999. Polio3 and DPT3 coverage improved in San Marcos, and BCG coverage in two departments. Overall, vaccination coverage of children under 1 in the three highlands areas met the Ministry of Health threshold of 80% coverage (2000 data will be available for comparison prior to the conference).
Learning Objectives: At the end of this presentation, the participants will be able to: 1. Describe the use of the PIA to strengthen processes. 2. Discuss the application of performance improvement to increase vaccination rates.
Keywords: Performance Measures, Child Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: University Research Corporation
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment