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[Quali-quantitative study on healthcare for children below the age of 3 at health establishments in nine underdeveloped regions of Peru].

OBJECTIVES
To assess five elements of healthcare quality (physical space, equipment, personnel, waiting time, and counseling) in growth and development services (GDS) at 18 healthcare establishments in nine regions of Peru with high rates of poverty.


MATERIALS AND METHODS
A quali-quantitative study was carried out in the Amazonas, Apurímac, Ayacucho, Cajamarca, Cusco, Huánuco, Huancavelica, Puno, and Ucayali regions, that included direct observation (DO) during medical assistance in GDS, focus groups (FG, one user per healthcare establishment), and in-depth interviews (IDI) with healthcare workers (two per healthcare establishment).


RESULTS
There were 18 DOs carried out to assess environment and equipment, 23 DOs of complete service shifts, 67 accompaniments to users during medical assistance in GDS, 18 FGs (118 participating mothers), and 36 IDIs. Both mothers and healthcare professionals agreed that there were limitations in infrastructure, equipment, materials, and personnel that impacted quality medical assistance in GDS. Delays in medical assistance, failure to comply with schedules, and lack of friendliness when providing medical care were the aspects that produced the greatest user dissatisfaction. Only 24.3% of the total amount of time spent at the healthcare establishment corresponded to beneficial activities for the user, although the Health Department was meeting the objective to promote improvement of childcare practices.


CONCLUSIONS
The study was useful in identifying weaknesses and strengths that may help redirect GDS efforts within the framework of policies aimed at strengthening first-class medical assistance.