[Factors explaining quality of primary health care in Logone Occidental (Chad)]

The extent of the deficit in human and financial resources associated with alarming health indicators in the developing countries has prompted us to undertake an evaluation of the quality of the primary health care provided in our country. The study was designed to identify the determinants of the quality of primary care delivered in the health centers of Western Logone in Chad by comparing systematic data collected from public and private health structures and an adapted questionnaire. Data were collected from 24 healthcare centers providing care for 395699 people, 73.1% of the population of the district of Logone Occidental. The average costs born by patients receiving care delivered by the different centers was not statistically different between the centers financed by public funds and those with denominational support: 944 Fcfa versus 1315 Fcfa. Variable statistically correlated with quality of care were: number of qualified healthcare workers in the center, training level of the center's manager, average patient-born cost of consultation, average healthcare expenditure per capita in the recruitment area (p<0.01). Considering the importance of the medical district in the organization of healthcare systems in the countries of Sub-Saharan Africa, quality assessment must become a continuous, supervised activity enabling proper description of the processes involved and propositions for local solutions designed to improve the quality of care.