[Program of quality assurance at the primary level of health care]

Health care quality assurance is an increasing demand of our social environmental, regarding not only high medical technology centers but, even more so, the services given at the primary care level, that covers the greater part of the population. In this paper we describe a quality assurance program implemented through "quality circles" within the immunization program of a primary health care center. The study was done in several stages. In the first two steps (preliminary diagnosis of the local immunization program, and coverage evaluation) the main problems affecting the program's quality were identified. In turn, these results allowed the implementation of the next phases: integration of the quality circles, elaboration of a quality assurance manual, and actual operation of the quality circles. A methodology first developed in a third level care institution was applied in this quality assurance program, which, on the other hand, showed immediate benefits on the services rendered.