Health facility management and primary health care performance in Uganda

dc.contributor.authorJune-Ho Kim
dc.contributor.authorGriffith A. Bell
dc.contributor.authorAsaf Bitton
dc.contributor.authorEesha V. Desai
dc.contributor.authorLisa R. Hirschhorn
dc.contributor.authorFredrick Makumbi
dc.contributor.authorElizabeth Nabiwemba
dc.contributor.authorHannah L. Ratcliffe
dc.contributor.authorFred Wabwire-Mangen
dc.contributor.authorSimon P. S. Kibira
dc.contributor.authorDan Schwarz
dc.date.accessioned2023-01-04T13:27:25Z
dc.date.available2023-01-04T13:27:25Z
dc.date.issued2022-03
dc.description.abstractAbstract 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.en_US
dc.identifier.citationKim, June-Ho, Griffith A. Bell, Asaf Bitton, et al. 'Health Facility Management and Primary Health Care Performance in Uganda', BMC Health Services Research, vol. 22/no. 1, (2022), pp. 275-275.en_US
dc.identifier.issn1472-6963
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6786
dc.language.isoenen_US
dc.publisherBioMed Central Ltden_US
dc.subjectManagement, Health facilities, Primary health care, Quality Essential drugsen_US
dc.titleHealth facility management and primary health care performance in Ugandaen_US
dc.typeArticleen_US
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