Increasing Access to Government Primary Care Health Facilities: Quality Improvements Matter

Antonio, Carl Abelardo T.
June 2014
Australian Journal of Basic & Applied Sciences;2014 Special, Vol. 8 Issue 8, p38
Academic Journal
Context - Government health facilities, which primarily cater to the poorer segments of a community, have a reputation for providing low-quality services. This results to low utilization of the facility, thereby exacerbating further inequities in healthcare. This paper reports on the results of a facility-level intervention to improve quality of care in a government primary care facility in a highly-urbanized city in the Philippines. Objective -To determine if there is a significant difference in the mean number of patients seen before and after implementing an intervention in a local health facility in a highly-urbanized city in the Philippines. Methodology -Facility N is a primary care facility owned and operated by a local government unit in a highly-urbanized city in the Philippines. Its catchment area is comprised of 11 barangays (villages) with an estimated population of 22,624. A three-pronged intervention to improve quality of service delivery was implemented consisting of a) staff demonstration of courtesy to patients, b) efficient case management, and c) consistency of service availability. Controlling for the day of the week, mean monthly patient case loads before the intervention (T0), and at one (T1), two (T2), three (T3), and four (T4) months post-intervention were compared using analysis of variance to determine if there is a significant differencein the number of patients seen before and after implementing the intervention at the 0.05 level of significance. This was supplemented with focus groups conducted among community representatives. Data was collected from August to December 2012, and analyzed in February 2013. Results -Mean (±standard deviation) patient case load increased over the study periods [T1 = 46 (±16), T2 = 45 (±20), T3 = 50 (±22) , and T4 = 36 (±21) ] compared to pre-intervention levels [ T0 = 34 (±17)]. Two-way analysis of variance showed that there is a difference in the mean number of patients seen in at least one time periods (p <0.001). Further analysis using Fisher-Hayter Pairwise comparison showed significant mean difference between T0 and T3 only. In the focus groups conducted among community representatives (government officials, housewives, lay health workers) before and at four months post-intervention, respondents noted the positive reception by community members of improvements being implemented in the health facility. Conclusion -Quality improvements in service delivery, especially in government facilities, are essential in expanding access to the health system, bridging the gap in health status between the poor and non-poor, and achieving the goal of universal health care.


Related Articles

  • Is your trust withholding funds?  // Primary Health Care;Mar2002, Vol. 12 Issue 2, p6 

    Reports on the budget for community nurses in England. Programs of the primary care groups and primary care trusts; Funding for community-based public health activities being undertaken by community practitioners; Organization of school health fairs; Program for fathers regarding male health...

  • How to contribute.  // Primary Health Care;Jul/Aug2002, Vol. 12 Issue 6, p16 

    Presents guidelines on how to contribute articles relevant to primary and community nursing.

  • Liberating the talents. Young, Lynn // Primary Health Care;Dec2002/Jan2003, Vol. 12 Issue 10, p14 

    Reports the relevance of the document on community nursing 'Liberating the Talents' for the nurses in primary care trust in Great Britain. Creation of the culture of freedom and liberation; Emphasis on the liberation of the talents and skills of the workforce; Identification of the core...

  • Developing community nurses. Bennett, Melanie; Thomas, Sharon // Primary Health Care;May2003, Vol. 13 Issue 4, p10 

    Reports on the innovative and development service for community nurses offered by East Leeds Primary Care Trust in England. Goal of the Nursing Supports and Development Team; Benefits of the team; Impact on the quality of service to patients and on staff morale.

  • Census reveals community focus on skin care.  // Nursing Standard;12/3/2008, Vol. 23 Issue 13, p7 

    The article reports on the Scotland's census, which reveals that skin conditions and wounds are the most common problems that are reported to community nurses. It is said that more than 3,000 primary care nurses have participated the Information Services Division Scotland census. It is cited...

  • The reality of Evercare. Asprey, Anne // Primary Health Care;May2004, Vol. 14 Issue 4, p21 

    Focuses on the Evercare Advanced Primary Nurse (APN) model of community nursing care, which has been imported from the United States and is being piloted in several primary care trusts in England. Focus on patient empowerment; Development of core competencies around the history and physical...

  • New year, new challenges. Cook, Rosemary // Primary Health Care;Feb2005, Vol. 15 Issue 1, p22 

    Describes the issues facing community nurses as outlined by the Director of Queen's Nursing Institute, Rosemary Cook in Great Britain. Concerns on the scarcity of nurses in the region; Changes to the dynamics of the total primary care workforce; Development of a concept of community matrons.

  • Sue Burke: a community matron with passsion.  // British Journal of Community Nursing;Nov2005, Vol. 10 Issue 11, p507 

    The article profiles Sue Burton, a Community Matron in Basildon Primary Care Trust. She started her district nurse training in 2003. While training, she noticed that many of her nursing home clients were not being assessed, because they had no obvious nursing need. Her subsequent career path has...

  • Promoting Excellence in Primary Care 2002: conference report. Pollard, Tom // British Journal of Community Nursing;Apr2002, Vol. 7 Issue 4, p173 

    Reports on the inaugural conference of the British Journal of Community Nursing in London, England. Theme of the convention; Condition of primary care nursing; Coverage of the plenary sessions.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics