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Despite the United Nations Millennium Development Goals and the 2030 Sustainable Development Goals, women in numerous countries still face many challenges in obtaining good-quality health care. For example, various nations in Latin America and the Caribbean (LAC) do not have access to complex radiology technologies. However, conventional radiography, ultrasound, mammography, and computed tomography are available and can be used to address such women's health concerns as breast and cervical cancers, postpartum bleeding, and tuberculosis. LAC countries face additional difficulties in radiology services with respect to quality human resources, quality assurance programs, standardization, and functioning of diagnostic imaging units. These deficiencies affect the quality of the services rendered. Appropriate measures must be implemented to produce quality services and quality images and to reduce adverse events. These steps will ensure better outcomes and consequently reduce mortality and morbidity. [ABSTRACT FROM AUTHOR]

Objective. To determine the correlation between certain quality indicators for imaging services and the accurate interpretation of radiological exams for four frequent complaints: breast lumps, gastrointestinal discomfort, back pain, and symptoms of tuberculosis. Methods. Twenty-six radiology services in Argentina, Bolivia, Colombia, Cuba, and Mexico were assessed. The mammography and conventional radiographic/fluoroscopic equipment used in selected services were evaluated utilizing common protocols, data sheets, testing instruments, phantoms, and calibrated dosimetry systems. The studies were performed in medium-complexity facilities. Informed consent was obtained from all patients studied, and the confidentiality of results was guaranteed. The following parameters were documented: type of facility (public vs. private); population covered; patient workload; radiological and image-processing equipment and supplies; education and training of professional and technical staff; quality assurance and preventive maintenance programs, and adherence to radiation safety standards. The performance of x-ray units, image receptors and processors; darkroom and image viewing conditions; patient doses and image quality, were determined using standardized parameters in all cases. Independent panels of radiologists, recognized as experts by the local radiological society, assessed the quality of the clinical images obtained and performed a radiological interpretation for each patient using the same films and clinical history available to the institution's imaging physicians. The agreement between the panel of expert's reports and those of local radiologists was taken as an indicator of the radiological diagnostic accuracy. Results. Analyses were carried out of 366 mammograms, 343 radiological procedures for gastrointestinal complaints, 319 X-rays of the spinal column, and 157 chest radiographs. The agreement between the radiological interpretation of the panel of experts and of the local physician ranged from 70% to 100%, except in the case of spinal column films in Cuba (57.8%) and of mammograms in Mexico (33.3%), which the panel of experts found to be among those having the poorest quality. There was a significant positive correlation between the accuracy of the radiological interpretation and the quality of the radiological images. Image quality showed a positive correlation with the technicians' level of education and training. Studies performed in services that had automatic film processors and that complied with the indicators established for screen-film contact yielded better images and a higher proportion of studies with concordant results. More than 50% of the viewboxes did not satisfy the quality criteria for luminance and homogeneity. Conclusions. A good quality image is critical to achieving an accurate diagnosis. Emphasis should be placed on the continuing education of radiology technicians and on the acquisition and maintenance of adequate equipment and accessories, especially viewboxes, intensifying screens, and automatic film processors, given the impact they have on image quality. [ABSTRACT FROM AUTHOR]