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Women Making a Difference

Norma Aly, Honduras
URC Country Director, USAID Health Care Improvement Project

By Lani Marquez and Jorge Hermida

Dr. Norma Aly is a physician with a passion for improving health care for women and children, especially those who are most vulnerable and socio-economically disadvantaged. Early in her medical career, working for a Honduran non-government organization, she saw the possibilities of mobilizing community organizations to improve the health situation for women and young children in Honduras’ rural and peri-urban communities. In 1999, Norma joined the staff of the Quality Assurance Project (QAP), funded by USAID, which was working in the Comayagua region of Honduras to reduce high rates of maternal mortality as part of USAID’s Latin American Mortality Reduction (LAMM) Initiative.

As the coordinator for the LAMM community mobilization component in Honduras, Norma trained and supported community volunteers to promote birth preparedness and increase awareness of danger signs among pregnant women in the communities surrounding the city of Comayagua. She also trained traditional birth attendants in clean delivery and the identification of signs of complications. Norma worked with community health committees to raise funds and establish mechanisms to provide emergency transport for women suffering obstetrical complications and to support the creation of a maternal waiting home, where high-risk women from rural areas could wait for delivery in the regional hospital.

Norma (third from the left) working with the quality improvement (QI) team at La Esperanza Hospital in May 2006.

In 2001, when QAP’s Country Director left to take another position, Norma was offered the position of leading URC’s program of USAID technical assistance to the Secretariat of Health in the area of quality assurance. She was not convinced she would be able to direct QAP activities in Honduras, but soon it became clear that she was a natural leader for such a program.  Her transparency, personal integrity, and excellent rapport with health personnel and partners at all levels made her a great technical team leader.

Deeply committed to the vision of making public health services both high quality and highly responsive to the needs of the poor, Norma has led the development of a health care quality improvement program that began in a few maternal care clinics and one hospital (Comayagua), to now encompass almost a hundred health facilities in eleven of Honduras’ 18 departments. Her patience and tenacity helped to convince the Secretariat of Health of Honduras to create its own quality units at the departmental level and have enabled the Secretariat to develop the necessary capacity and leadership to institutionalize a modern, evidence-based quality improvement program.

Norma found a natural partner in Dr. Rosario Cabañas, who was named the first head of Honduras’ National Quality Assurance Department. With support from Norma and her QAP team, Dr. Cabañas has worked to make QI an integral part of the Secretariat of Health’s organizational structure, institutionalizing quality assurance responsibilities and activities at all levels of the health system. The success of the QI work supported by USAID has led other agencies, such as the World Bank and the Swedish Cooperation, as well as NGOs such as Christian Children’s Fund, to invest in the National Quality Assurance Department’s program, to further spread the use of tools and approaches developed by Dr. Aly and her colleagues.

Today, the quest for high quality health services is an irreversible trend in the Honduran health system, thanks in no small way to the vision and dedication of Dr. Norma Aly.

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