Clara Contrera had been thinking for months about how to improve primary care for her patients. She is a general practitioner at the El Rodeo Comprehensive Health Center, located nearly three hours from Tegucigalpa, the capital of Honduras. There, she treats patients of all ages, many of whom live in poverty. With years of experience as a health professional, she recognizes that her country has made significant progress in terms of health service coverage, but that there are still gaps to be closed in terms of quality of care.
Studies show that the quality of healthcare can vary greatly, even when resources are available. And having clinical knowledge alone does not guarantee it will be consistently applied in daily practice. The key to ensuring quality care lies not only in supplies or standards, but also in well-coordinated health teams with clear processes, measurable standards, and ongoing cycles of evaluation and learning.
Like many healthcare professionals in the region, Clara wanted to take the next step toward improving care quality for her patients. But despite her efforts, she could not find a way to achieve it — until now.
An Innovative Approach: Coaching for Continuous Improvement
Between 2022 and 2023, the Salud Mesoamerica Initiative (SMI) — in collaboration with the Ministry of Health of Honduras and Global Access — implemented an innovative Quality Continuous Improvement Management and Coaching Program in three municipalities in the country. The program was born out of the concern of thousands of healthcare professionals who, like Clara, wanted to make a difference. They sought to foster a culture that empowered staff and made feedback and innovation true pillars of care.
The challenge was not easy. In collaboration with SMI and the Ministry of Health, our goal was to enhance primary healthcare through the development of soft skills. The objective was to transform team leaders into mentors and coaches, capable of guiding their colleagues through demonstration, motivation, and feedback. In doing so, we aimed to strengthen work organization and raise care quality, particularly in two key areas with significant gaps: prenatal care and early detection of cervical cancer (see chart).
The Quality Gap: Honduras 2019
In 2019, 94% of pregnant women in Honduras attended at least one prenatal check-up in municipalities with higher levels of poverty, but only 73% received quality prenatal care. Similarly, while 48% of women underwent cervical cancer screening, only 32% received it with quality.
The program combined the development of technical and soft skills for 45 mid-level professionals. Participants included coordinators and supervisors from seven Decentralized Health Management Organizations in the regions of Lempira, Intibucá, and Choluteca, as well as regional and central Ministry of Health staff. Collectively, these mid-level managers oversee 93 primary care units serving nearly 335,000 people. Clara Contrera was one of them.
| Technical Skills | Soft Skills |
|---|---|
| Measuring quality indicators based on care processes, data analysis, and developing improvement plans based on that analysis. | Coaching, leadership, effective feedback, communication, team building, and conflict resolution. |
The Impact of Fostering Soft Skills in Health Teams
To assess the program’s impact, a population-based impact evaluation was conducted, which will be published soon. The data showed significant progress: coverage of quality cervical cancer screening increased by 13 percentage points (almost closing the quality gap identified before the program). This means women not only received the exam but also got their results within one month. This improvement enables early detection and increases survival rates in positive cases. Quality prenatal care coverage also rose by 6 percentage points, although this result is not statistically significant.
The program confirms that the quality of health services does not depend solely on supplies or clinical knowledge but also on the capacity of teams to work in coordination, learn continuously, and innovate in their daily practice.
Today, Clara Contrera has renewed her commitment to her patients. The program led by SMI and the Ministry of Health transformed the way she works. “I feel more capable of leading my team, resolving conflicts, generating ideas for change, and, above all, providing quality care to the population,” she says. “It has helped me so much that I barely recognize myself,” she adds, moved.
The results show that improving healthcare quality goes beyond material resources. It is about empowering human talent, transforming how professionals interact with their teams and patients, and building a culture of learning and continuous improvement.
In challenging contexts, where every effort counts to reduce quality gaps, this comprehensive approach demonstrates that healthcare can be not only more effective, but also more human-centered.
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