Determinants of primary care service quality in Afghanistan

Hansen, Peter M.; Peters, David H.; Edward, Anbrasi; Gupta, Shivam; Arur, Aneesa; Niayesh, Haseebullah; Burnham, Gilbert

doi:10.1093/intqhc/mzn039

Cited by 32 publications

(30 citation statements)

References 21 publications

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“…23 Similarly, in a study from Uganda, the quality index was 44% higher in facilities with at least one provider trained in IMCI, 24 a finding that further strengthens the case for greater investments in IMCI. We found that the proportion of providers ( Table 4, cont.)…”

Section: Discussionmentioning

confidence: 90%

Trends in the quality of health care for children aged less than 5 years in Afghanistan, 2004–2006

Edward¹,

Dwivedi²,

Mustafa³

et al. 2009

Bull World Health Org

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Section: Discussionmentioning

confidence: 90%

Trends in the quality of health care for children aged less than 5 years in Afghanistan, 2004–2006

Edward¹,

Dwivedi²,

Mustafa³

et al. 2009

Bull World Health Org

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“…Recognition of these two services as best functioning services does not mean that they are working perfectly and do not suffer from shortcomings. Studies from Afghanistan and Nigeria have also reported a generally better satisfaction with maternal and child care services in PHCCs compared to other services [47,48]. There was also a general consensus about devoting inadequate time to patients at antenatal care.…”

Section: Discussionmentioning

confidence: 99%

Women’s views and experiences of antenatal care in Iraq: a Q methodology study

Shabila

Ahmed

Yasin³

2014

BMC Pregnancy Childbirth

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BackgroundUnderstanding women’s experiences and perspectives of antenatal care services is particularly critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations. As part of a comprehensive assessment of the maternity care services in Iraq, this study aimed to explore the views and experiences of antenatal care in a sample of women.MethodsThis explorative study was conducted in Erbil governorate, Iraq. Data were collected using Q methodology, a technique for eliciting subjective views and identifying shared patterns among individuals. A sample of 38 women of different educational and socioeconomic statuses were invited to sort a set of 39 statements reflecting different aspects of the available antenatal care services and issues related to their last pregnancies into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was used to derive latent views through centroid factor extraction and varimax rotation of factors.ResultsAnalysis of the participants’ Q sorts resulted in identifying four distinct views and experiences of pregnancy and antenatal care services: (i) public maternity services second best: preference for, and ability to afford, private care, (ii) dissatisfaction with public maternity services: poor information sharing and lack of health promotion, (iii) satisfaction with public maternity service but information gaps perceived and (iv) public maternity services second best: preference for private care but unaffordable. The typical characterizations that were associated with each view were highlighted.ConclusionsThis study revealed different patterns of views and experiences of women of pregnancy and antenatal care services and recognized the particular issues related to each pattern. Different patterns and types of problems and concerns related mainly to inadequate provision of information and poor interpersonal communication, poor utilization of public services and a general preference to use private services were identified in the different groups of women.

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“…Interestingly, users from households with a head who had some education were less likely to be satisfied; perhaps they look for higher standards. A study based on data collected from primary health care facilities in Afghanistan in 2004 found that poorer service users got better quality of service in NGO-contracted facilities than directly managed government facilities [15]. …”

Section: Discussionmentioning

confidence: 99%

Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience

Cockcroft

Khan

Ansari³

et al. 2011

BMC Health Serv Res

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BackgroundIn rebuilding devastated health services, the government of Afghanistan has provided access to basic services mainly by contracting with non-government organisations (NGOs), and more recently the Strengthening Mechanism (SM) of contracting with Provincial Health Offices. Community-based information about the public's views and experience of health services is scarce.MethodsField teams visited households in a stratified random sample of 30 communities in two districts in Kabul province, with health services mainly provided either by an NGO or through the SM and administered a questionnaire about household views, use, and experience of health services, including payments for services and corruption. They later discussed the findings with separate community focus groups of men and women. We calculated weighted frequencies of views and experience of services and multivariate analysis examined the related factors.ResultsThe survey covered 3283 households including 2845 recent health service users. Some 42% of households in the SM district and 57% in the NGO district rated available health services as good. Some 63% of households in the SM district (adjacent to Kabul) and 93% in the NGO district ordinarily used government health facilities. Service users rated private facilities more positively than government facilities. Government service users were more satisfied in urban facilities, if the household head was not educated, if they had enough food in the last week, and if they waited less than 30 minutes. Many households were unwilling to comment on corruption in health services; 15% in the SM district and 26% in the NGO district reported having been asked for an unofficial payment. Despite a policy of free services, one in seven users paid for treatment in government facilities, and three in four paid for medicine outside the facilities. Focus groups confirmed people knew payments were unofficial; they were afraid to talk about corruption.ConclusionsHouseholds used government health services but preferred private services. The experience of service users was similar in the SM and NGO districts. People made unofficial payments in government facilities, whether SM or NGO run. Tackling corruption in health services is an important part of anti-corruption measures in Afghanistan.

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Determinants of primary care service quality in Afghanistan

Cited by 32 publications

References 21 publications

Trends in the quality of health care for children aged less than 5 years in Afghanistan, 2004–2006

Trends in the quality of health care for children aged less than 5 years in Afghanistan, 2004–2006

Women’s views and experiences of antenatal care in Iraq: a Q methodology study

Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience

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