Affiliation:
1. Department of Family Medicine, School of Medicine, Makerere University College of Health Sciences
2. Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University
Abstract
Abstract
Background
In order to strengthen primary health care (PHC), there is a need to measure its performance. The World Health Organisation has published a measurement framework for PHC. This framework emphasised the core functions of primary care: access, continuity, coordination, comprehensiveness and person-centredness. This study aimed to measure the performance of primary care using the Primary Care Assessment Tool (PCAT) in one rural Ugandan district.
Methods
A cross-sectional survey of Tororo District administered the PCAT across a sample of 51/58 PHC facilities. There were four levels of health facilities (health centres II to general hospital). A random sample of at least 100 users was obtained from each level, and from all primary care providers and managers. Data was collected in REDCap software, and analysed in the Statistical Package for Social Sciences vs23.
Results
Only 35.1% of users had a strong affiliation with their PHC facility. The overall primary care score suggested that performance was acceptable to the majority of users (58.9% rating the performance at least acceptable). Ongoing care was rated by users as very poor (< 25% of people rating it at least acceptable). Comprehensiveness (services available) was rated as poor by users (≤ 50% finding it at least acceptable). Users rated first contact access and coordination (information systems) as acceptable (51–75% finding them at least acceptable). Person-centredness and comprehensiveness (services provided) were rated as good by users (> 75% rating them as acceptable or more). Providers and users differed significantly in their scoring across all domains, with providers usually more positive. Performance significantly improved as the PHC level increased, with the general hospital having the highest score.
Conclusion
The PCAT was able to identify the primary care functions that needed improving. The results will be used to co-design interventions to improve performance. The PCAT may be a useful tool to measure PHC performance across the region.
Publisher
Research Square Platform LLC
Reference38 articles.
1. World Health Organization. Declaration of Alma-Ata 1978 [cited 2022 10/08/2022]. Available from: https://www.who.int/docs/default-source/documents/almaata-declaration-en.pdf.
2. Selective primary health care: an interim strategy for disease control in developing countries;Walsh JA;Social Sci Med Part C: Med Econ,1980
3. Alma Ata after 40 years: Primary Health Care and Health for All-from consensus to complexity;Rifkin SB;BMJ Glob Health,2018
4. Van Lerberghe W. The world health report 2008: primary health care: now more than ever. Geneva: World Health Organization; 2008.
5. World Health Organisation. Quality health services Geneva: WHO; 2022 [cited 2023 02/01/2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/quality-health-services.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献