Management assessment of primary health care services in the Peru Ministry of Health

This evaluation of child survival programs in Peru utilizes a systems assessment model, developed under the PRICOR project, which aims at yielding a detailed quality assurance profile of service delivery while providing immediate feedback to health workers and managers participating in the assessment. The study involved 54 health centers throughout the country. Five major findings are presented. (1) Health workers perform technical tasks far better than they perform promotional/educational efforts. (2) Problems resulting from a lack of awareness on the part of health workers and local deficiencies in the organization of services appear to be more important determinants of performance than lack of motivation, supplies, or program strategies. (3) Health workers have a high level of job satisfaction despite current budget problems. (4) In communities closest to health centers, basic coverage is below desirable levels in all programs, but significantly better for child survival than for maternal health and family planning. (5) Mothers are generally satisfied with the technical aspects of services, but less so with the manner in which they are treated and the educational services provided. It was found that mothers" basic knowledge in virtually all key program areas is poor. The assessment also demonstrated the value of the systems assessment model to attain the goals for which it was developed.