Health services quality improvement in Guaymate, Dominican Republic, as the framework for US global health education: a case study

Abstract

Background: We explored the feasibility of a partnership approach between the community, the US Peace Corps, and the University of Illinois to improve the quality of local primary health-care services in Guaymate, Dominican Republic. The aim was to do community-based participatory research (CBPR) as a framework for responsible global health education for US trainees. Methods: We used mixed methods to characterise the partnership, assess the health service effect of a quality improvement process, and qualitatively examine the value of the global health education experience. Outcome variables include partner contributions and benefits to assess the partnership; client perceptions of access, safety, and continuity to assess service quality; and US trainee perceptions of personal and community effect to assess global health education. We used CBPR to identify local priorities for health service quality improvement. Findings: Within the partnership, the local health institution leadership guides the project in consideration of local priorities; the Peace Corps provides coordination support, community expertise, and local trust; and the academic institution offers technical, public health, and research support. The local community benefits through improved access to quality primary health care services. US trainees learn principles of primary health care, community participation, social determinants of health, and health services strengthening. Local priorities identified for health service quality improvement were at the local municipal hospital and community health education. Interpretation: This partnership approach has been successfully implemented in Guaymate, Dominican Republic, and has shown promise as a generalisable model. The anticipated partnership outcome is local primary health-care quality improvement that sustainably addresses locally prioritised public health issues within a responsible approach to global health education. Funding: Northwestern University School of Law.