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Quality programs are difficult to implement where social support for healthcare costs are inadequate and there is no institutional support for quality programs to guide and assist the doctor in pratice. 'Quality' is not the good intention to do better, but the process of measurement of behavioral change against set targets. For the majority of the doctors of this region who practice under great constraints, this article outlines some quality activities that are entirely within their personaldoi:10.1046/j.1444-1683.2002.00036.x fatcat:kzpczxa7mbg33d2mt4fa24tpxe