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

  vertical bar 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.'
affiliation: 'Rohloff, P (Corresponding Author), Wuqu Kawoq Maya Hlth Alliance, Santiago
  Sacatepequez, Guatemala.

  Colom, Marcela; Austad, Kirsten; Sacuj, Neftali; Rohloff, Peter, Wuqu Kawoq Maya
  Hlth Alliance, Santiago Sacatepequez, Guatemala.

  Austad, Kirsten, Brigham \& Womens Hosp, Div Womens Hlth, 75 Francis St, Boston,
  MA 02115 USA.

  Larson, Karen, Friendship Bridge, Lakewood, CO USA.

  Rohloff, Peter, Brigham \& Womens Hosp, Div Global Hlth Equ, 75 Francis St, Boston,
  MA 02115 USA.'
author: Colom, Marcela and Austad, Kirsten and Sacuj, Neftali and Larson, Karen and
  Rohloff, Peter
author-email: peter@wuqukawoq.org
author_list:
- family: Colom
  given: Marcela
- family: Austad
  given: Kirsten
- family: Sacuj
  given: Neftali
- family: Larson
  given: Karen
- family: Rohloff
  given: Peter
da: '2023-09-28'
doi: 10.1016/j.hjdsi.2017.12.003
eissn: 2213-0772
files: []
issn: 2213-0764
journal: HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION
keywords: 'Primary healthcare; Guatemala; Women''s health; Quality improvement;

  Social networks; Microfinance'
keywords-plus: 'PANEL-DATA; BANGLADESH; IMPROVEMENT; POVERTY; AFRICA; IMPACT;

  INTERVENTIONS; FRAMEWORK; HIV'
language: English
month: DEC
number: '4'
number-of-cited-references: '46'
orcid-numbers: 'Rohloff, Peter/0000-0001-7274-8315

  Austad, Kirsten/0000-0001-5237-2955

  Sacuj, Neftali/0000-0001-9838-9293'
pages: 223-230
papis_id: afeed4493b102b429151210036d1b7ca
ref: Colom2018expandingaccess
researcherid-numbers: 'Rohloff, Peter/P-8722-2017

  Austad, Kirsten/ABC-7684-2021

  '
times-cited: '2'
title: 'Expanding access to primary healthcare for women through a microfinance institution:
  A case study from rural Guatemala'
type: Article
unique-id: WOS:000450806500001
usage-count-last-180-days: '0'
usage-count-since-2013: '12'
volume: '6'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2018'