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Expanding access to primary healthcare for women through a microfinance institution: A case study from rural Guatemala

机译：通过小额信贷机构扩大对妇女的主要医疗保健：危地马拉农村的案例研究

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ABSTRACT The utilization of existing social networks is increasingly being recognized as a powerful strategy for delivering healthcare services to underserved populations in low- and middle-income countries. In Guatemala, multiple barriers prevent access to healthcare services for rural and indigenous populations, and strategies for delivering healthcare in more efficient ways are needed. The case study we describe here is a unique collaboration between a microfinance institution (Friendship Bridge) and a primary care organization (Wuqu' Kawoq | Maya Health Alliance) to scale up healthcare through an existing lending-borrowing social network. The program provides primary care services to female clients of Friendship Bridge in rural areas of Guatemala, with nurses working as frontline primary care providers, providing door-to-door healthcare services. Over the first 22 months of the project, we have reached over 3500 of Friendship Bridge's clients, with overall high acceptance of services. All clinical documentation and program monitoring and evaluation are done through audit trails within an electronical medical record system, which improves efficiency and lowers the associated time and resources costs. We utilize quality improvement methodologies to aid in decision making and programmatic adjustments scale up. These strategies have allowed us to expand services rapidly under challenging geographic and logistical constraints, while concurrently iteratively improving staff training and supervision, clinical care, and client engagement processes.
机译：摘要现有社交网络的利用越来越被认为是在低收入和中等收入国家提供医疗保健服务的强大战略。在危地马拉，多个障碍防止获得农村和土着人口的医疗保健服务，并需要以更有效的方式提供医疗保健的策略。我们描述的案例研究是小额信贷机构（友谊桥）和初级保健组织（Wuqu'Kawoq | Maya Health Alliance）之间的独特合作，通过现有的借贷社交网络扩大医疗保健。该计划为危地马拉农村友谊桥的女性客户提供初级保健服务，护士担任前线初级保健提供商，提供门到门的医疗保健服务。在该项目的前22个月内，我们已达到3500多个友谊桥的客户，全面接受服务。所有临床文档和计划监测和评估都是通过电子医疗记录系统内的审计跟踪完成的，这提高了效率并降低了相关的时间和资源成本。我们利用质量改进方法来帮助决策和规划调整扩大。这些策略使我们能够在挑战地理和后勤约束下快速扩展服务，同时同时迭代地改善员工培训和监督，临床护理和客户参与过程。

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