Primary care performance in a Ugandan rural district: a cross-sectional descriptive study

Area of Science:

• Global health
• Health services research
• Primary health care evaluation

Background:

• Strengthening primary health care (PHC) requires robust performance measurement.
• Global recommendations advocate for patient involvement in service improvement.

Purpose of the Study:

• To measure primary health care performance in a rural Ugandan district.
• To assess patient and provider perceptions of PHC services.

Main Methods:

• A cross-sectional survey was conducted in Tororo District, Uganda.
• The Ugandan Primary Care Assessment Tool (UG-PCAT) was administered to 51 facilities across four levels.
• Data from 488 users and all primary care providers/managers were collected and analyzed.

Main Results:

• Overall PHC performance was rated acceptable by 58.9% of users, but ongoing care and comprehensiveness were rated poorly.
• User affiliation with facilities was low (35.1%).
• Providers rated services more positively than users, and performance improved with higher facility levels.

Conclusions:

• Primary health care performance in the studied district was suboptimal.
• The UG-PCAT effectively identified areas needing improvement in PHC functions.
• The UG-PCAT is a potentially valuable tool for regional PHC performance measurement.