La gestión administrativa en la Institución Conagopare, provincia de Cotopaxi, cantón Latacunga periodo 2023

This research work was developed with the objective of diagnosing the Administrative Management in CONAGOPARE Province of Cotopaxi, Canton Latacunga. Administrative management is not a topic that should be taken lightly, since effective management will help the institution in the execution of various activities aimed at coordinating all available resources to comply with the established objectives. One of the main purposes of the research is to collaborate in the gradual and successful improvement of the Administrative Management of CONAGOPARE Cotopaxi. Based on important factors taken from various theories and scientific thoughts of authors with knowledge on the subject, for this reason the methodology used has a quantitative approach, with a non-experimental design and applying cross-sectional studies, in addition to an explanatory and field research. We also applied the survey technique and its instrument called questionnaire, applied to the 10 employees of the institution, the instrument in question is made up of 23 questions based on administrative management, it is also divided into 5 dimensions that establish planning, organization, direction, control and management. The questionnaire helped us to gather precise information on the current state of the organization. In the results of the situational diagnosis it was identified that the Administrative Management of CONAGOPARE Cotopaxi presented a series of deficiencies, for example: low participation of the collaborators in the elaboration of plans and projects of the institution with 30% of negative results, on the other hand it was detected the lack of recognition for work performance with 50% of negativity, in addition it was identified that there is little use of tools for decision making according to 40% of results and finally it was determined the lack of productivity in problem solving with 40% of unfavorable results, This was a great reason to direct the research proposal that focused on the development of strategies for the improvement of administrative management in the institution CONAGOPARE Cotopaxi, within the strategies provided we find the promotion of effective communication, incorporate recognition for job performance, improve decision making and improvement in the management of CONAGOPARE Cotopaxi, it should be noted that each of the proposed strategies are made up of activities, participants, times and respective costs for future implementation. It is also valid to note that the implementation of the proposed strategies will generate economic xi impacts, since the implementation of the proposed strategies will require a considerable economic investment for greater effectiveness; on the other hand, the technical impact generated in the collaborators will also be notable, since the work team will have to adapt to new techniques, knowledge and requirements of the institution. It should also be noted that the beneficiaries will be the internal and external collaborators of the organization. For this reason, it is important to state that this study will contribute to the generation of new knowledge for the professionals of the institution, as well as for future research.El presente trabajo investigativo se desarrolló con el objetivo de diagnosticar la Gestión Administrativa en CONAGOPARE Provincia de Cotopaxi, Cantón Latacunga. La Gestión administrativa no es un tema que deba ser tomado a la ligera, puesto que, el gestionar de manera efectiva ayudará a la institución a la ejecución de diversas actividades orientadas a coordinar todos los recursos disponibles para dar cumplimiento con los objetivos establecidos. Uno de los principales propósitos de la investigación es colaborar en la mejora paulatina y exitosa de la Gestión Administrativa de CONAGOPARE Cotopaxi. Partiendo de factores importantes tomados de diversas teorías y pensamientos científicos de autores con conocimientos sobre el tema, por tal razón la metodología utilizada tiene un enfoque cuantitativo, con un diseño no experimental y aplicando estudios transversales, además de una investigación explicativa y de campo. También se aplicó la técnica de la encuesta y su instrumento denominado cuestionario, aplicado a los 10 funcionarios de la institución, el instrumento en mención está conformado por 23 preguntas en base a la gestión administrativa, asimismo está dividida en 5 dimensiones que establece la planificación, organización, dirección, control y gestión. El cuestionario nos ayudó a recabar información precisa sobre el estado actual en que se encuentra la organización. En los resultados del diagnóstico situacional se pudo identificar que la Gestión Administrativa de CONAGOPARE Cotopaxi presentó una serie de deficiencias como por ejemplo: poca participación de los colaboradores en la elaboración de planes y proyectos de la institución con el 30% de resultados negativos, por otro lado se detectó la falta de reconocimientos por el rendimiento laboral con un 50% de negatividad, además se identificó que existe poca utilización de herramientas para la toma de decisiones de acuerdo con el 40% de resultados y finalmente se determinó la falta de productividad en la solución de problemas con el 40 % de resultados desfavorables, siendo aquello un gran motivo para encaminar la propuesta investigativa que se enfocó en la elaboración de estrategias para el mejoramiento de la gestión administrativa en la institución CONAGOPARE Cotopaxi, dentro de las estrategias proporcionadas encontramos el fomentar una comunicación efectiva, incorporar el reconocimiento para el desempeño laboral, mejorar la toma de decisiones y mejora en la gestión de ix CONAGOPARE Cotopaxi, cabe recalcar que cada una de las estrategias propuestas se encuentran conformadas de actividades, participantes, tiempos y costos respectivos para su futura implementación. También es válido acotar que la ejecución de las estrategias propuestas generara impactos económicos pues para la ejecución de las estrategias planteadas se requiere de una inversión económica considerable para una mayor efectividad, por otro lado el impacto técnico generado en los colaboradores también será notable, pues el equipo de trabajo deberá acoplarse a nuevas técnicas, conocimientos y requerimientos de las institución. Así mismo, cabe recalcar que los beneficiarios serán los colaboradores internos y externos de la organización. Por tal razón es importante exponer que el presente estudio aportará con la generación de nuevos conocimientos tanto para los profesionales de la institución, así como también para futuras investigaciones

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030