Luckson Wandani Dullie
University of Bergen, Norway
Title: Primary care organization and performance: A cross sectional study of outpatients’ experience in Malawi
Biography
Biography: Luckson Wandani Dullie
Abstract
Background: Assessing patients’ experience with primary care compliments measures of clinical health outcomes in evaluating its performance. Measuring patients’ experience and satisfaction are among Malawi’s health sector strategic goals. The purpose of this study was to investigate patients’ experience with primary care and to assess associated patients’ sociodemographic, healthcare and health characteristics.
Methods: This was a cross sectional survey using questionnaires administered in primary care facilities in Neno district, Malawi. Face to face interviews using a validated Malawian version of the primary care assessment tool (PCAT-Mw) were carried out to collect data on patients’ primary care experience and their sociodemographic, healthcare and health characteristics. Total primary care and domain mean scores were derived for access, continuity, comprehensiveness and community orientation. Linear regression models were used to assess association between primary care attribute scores and patients’ characteristics.
Results: From 631 completed questionnaires, first contact-access, relational continuity and comprehensiveness of services available scored below the accepted minimum. Sex, geographical location, self-rated health status, duration of contact with facility and facility affiliation were associated with patients’ experience with primary care. These factors explained 10.9% of the
noted variance in total primary care scores; 25.2% in comprehensiveness of services available and 29.4% in first contact access.
Conclusion: This paper presents results from the first use of the validated PCAT-Mw. The study provides a baseline for defining quality improvement gaps and can be used alongside clinical health outcome studies to provide comprehensive evaluation of primary care performance in Malawi