The new public health law and the intervention of the patient advocate a correctable omission

Abstract

Within the current legal framework, this study 
analyzed the relationship between job performance and administrative processes in the Decentralized Autonomous Government of Quinindé, Esmeraldas Province, Ecuador. 
Factors limiting institutional efficiency were identified, and improvement strategies were proposed. A mixed-method approach was used, including surveys, semi-structured interviews, and document analysis. The study population consisted of 312 administrative employees, from which a sample of 164 participants was selected. The results indicated that a lack of clarity in organizational objectives and the absence of feedback negatively affected job performance. Although progress was observed in strategic and organizational planning, internal communication and leadership deficiencies persisted—the scarcity of training programs and the limited adoption of technologies negatively impacted management. The internal control system was found to be insufficient to ensure transparency and operational efficiency. Strengthening leadership, implementing training programs, incorporating technologies, and improving internal control are recommended to optimize administrative processes. Finally, citizen 
participation was highlighted as a key factor in legitimizing institutional management and strengthening the government and community relationship.