Difficulties involved in taking health services to the people: the example of a public health care center in a Caracas barrio.

This paper discusses the difficulties faced by a typical Ministry of Health and Social Welfare maternal and infant health care services center. These service modules are usually located in the lower income barrios of Venezuela's urban centers. Recent experiences as seen by supervisors of the regional and district offices of the Ministry and the center's staff were evaluated following in-depth interviews, direct observation and scanning of clinical records over a three month period. The study concludes that the major problem areas influence the Ministry's primary goal of extending coverage to a greater proportion of the needy population and maintain the quality of the services: inadequate administrative structure leading to logistics difficulties; and the clinic location and the characteristics of the barrio itself and of the client population.