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Health facility management and primary health care performance in Uganda
BACKGROUND: Primary health care is a critical foundation of high-quality health systems. Health facility management has been studied in high-income countries, but there are significant measurement gaps about facility management and primary health care performance in low and middle-income countries....
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886189/ https://www.ncbi.nlm.nih.gov/pubmed/35232451 http://dx.doi.org/10.1186/s12913-022-07674-3 |
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author | Kim, June-Ho Bell, Griffith A. Bitton, Asaf Desai, Eesha V. Hirschhorn, Lisa R. Makumbi, Fredrick Nabiwemba, Elizabeth Ratcliffe, Hannah L. Wabwire-Mangen, Fred Kibira, Simon P. S. Schwarz, Dan |
author_facet | Kim, June-Ho Bell, Griffith A. Bitton, Asaf Desai, Eesha V. Hirschhorn, Lisa R. Makumbi, Fredrick Nabiwemba, Elizabeth Ratcliffe, Hannah L. Wabwire-Mangen, Fred Kibira, Simon P. S. Schwarz, Dan |
author_sort | Kim, June-Ho |
collection | PubMed |
description | BACKGROUND: Primary health care is a critical foundation of high-quality health systems. Health facility management has been studied in high-income countries, but there are significant measurement gaps about facility management and primary health care performance in low and middle-income countries. A primary health care facility management evaluation tool (PRIME-Tool) was initially piloted in Ghana where better facility management was associated with higher performance on select primary health care outcomes such as essential drug availability, trust in providers, ease of following a provider’s advice, and overall patient-reported quality rating. In this study, we sought to understand health facility management within Uganda's decentralized primary health care system. METHODS: We administered and analyzed a cross-sectional household and health facility survey conducted in Uganda in 2019, assessing facility management using the PRIME-Tool. RESULTS: Better facility management was associated with better essential drug availability but not better performance on measures of stocking equipment. Facilities with better PRIME-Tool management scores trended towards better performance on a number of experiential quality measures. We found significant disparities in the management performance of primary health care facilities. In particular, patients with greater wealth and education and those living in urban areas sought care at facilities that performed better on management. Private facilities and hospitals performed better on the management index than public facilities and health centers and clinics. CONCLUSIONS: These results suggest that investments in stronger facility management in Uganda may strengthen key aspects of facility readiness such as essential drug availability and potentially could affect experiential quality of care. Nevertheless, the stark disparities demonstrate that Uganda policymakers need to target investments strategically in order to improve primary health care equitably across socioeconomic status and geography. Moreover, other low and middle-income countries may benefit from the use of the PRIME-Tool to rapidly assess facility management with the goal of understanding and improving primary health care performance. |
format | Online Article Text |
id | pubmed-8886189 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88861892022-03-01 Health facility management and primary health care performance in Uganda Kim, June-Ho Bell, Griffith A. Bitton, Asaf Desai, Eesha V. Hirschhorn, Lisa R. Makumbi, Fredrick Nabiwemba, Elizabeth Ratcliffe, Hannah L. Wabwire-Mangen, Fred Kibira, Simon P. S. Schwarz, Dan BMC Health Serv Res Research BACKGROUND: Primary health care is a critical foundation of high-quality health systems. Health facility management has been studied in high-income countries, but there are significant measurement gaps about facility management and primary health care performance in low and middle-income countries. A primary health care facility management evaluation tool (PRIME-Tool) was initially piloted in Ghana where better facility management was associated with higher performance on select primary health care outcomes such as essential drug availability, trust in providers, ease of following a provider’s advice, and overall patient-reported quality rating. In this study, we sought to understand health facility management within Uganda's decentralized primary health care system. METHODS: We administered and analyzed a cross-sectional household and health facility survey conducted in Uganda in 2019, assessing facility management using the PRIME-Tool. RESULTS: Better facility management was associated with better essential drug availability but not better performance on measures of stocking equipment. Facilities with better PRIME-Tool management scores trended towards better performance on a number of experiential quality measures. We found significant disparities in the management performance of primary health care facilities. In particular, patients with greater wealth and education and those living in urban areas sought care at facilities that performed better on management. Private facilities and hospitals performed better on the management index than public facilities and health centers and clinics. CONCLUSIONS: These results suggest that investments in stronger facility management in Uganda may strengthen key aspects of facility readiness such as essential drug availability and potentially could affect experiential quality of care. Nevertheless, the stark disparities demonstrate that Uganda policymakers need to target investments strategically in order to improve primary health care equitably across socioeconomic status and geography. Moreover, other low and middle-income countries may benefit from the use of the PRIME-Tool to rapidly assess facility management with the goal of understanding and improving primary health care performance. BioMed Central 2022-03-01 /pmc/articles/PMC8886189/ /pubmed/35232451 http://dx.doi.org/10.1186/s12913-022-07674-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kim, June-Ho Bell, Griffith A. Bitton, Asaf Desai, Eesha V. Hirschhorn, Lisa R. Makumbi, Fredrick Nabiwemba, Elizabeth Ratcliffe, Hannah L. Wabwire-Mangen, Fred Kibira, Simon P. S. Schwarz, Dan Health facility management and primary health care performance in Uganda |
title | Health facility management and primary health care performance in Uganda |
title_full | Health facility management and primary health care performance in Uganda |
title_fullStr | Health facility management and primary health care performance in Uganda |
title_full_unstemmed | Health facility management and primary health care performance in Uganda |
title_short | Health facility management and primary health care performance in Uganda |
title_sort | health facility management and primary health care performance in uganda |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886189/ https://www.ncbi.nlm.nih.gov/pubmed/35232451 http://dx.doi.org/10.1186/s12913-022-07674-3 |
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