Assessment of the Quality of Primary Health Care services in Al-Ramadi City, West of Iraq


Background: Quality of care is an important aspect of health care delivery system that should be given a priority. The fact that primary health care includes the provision of many services that are essential heightens the importance of assessing its quality. Aim of the study: To assess the quality of healthcare services provided by PHC centres in Al Ramadi City. Methodology: A cross sectional study design was employed to assess the quality of primary healthcare with respect to structure, consumer and care provider satisfaction, involving 600 clients and 150 care providers in Al Ramadi, West of Iraq from October 2012 to February 2013. Structure was assessed by observation of available items and comparing them with a checklist of standards recommended by the Ministry of Health for PHC centers. Data were also collected using an interview questionnaire for clients and self-administered questionnaire for care providers.Results: The overall adequacy rates for the availability of structure items were 71.3% and 72.5% in main and sub centers respectively. This is regarded as acceptable structure compared to the ideal or expected requirements. The least component of structure items available was the number of medical and paramedical staff. Deficiency of equipments and supplies was noticed in some centers. Clients' perception about the quality of PHC services showed that about 47 % of clients expressed positive views and general satisfaction towards all services provided, the highest proportion (64.8%) were satisfied with cost of services being cheap, while the lowest proportion, only 13.7% were satisfied with availability of doctors in the centers. About 59.3% of care providers expressed an overall work satisfaction. The majority reported satisfaction with support by their managers, and with staff collaborations. The least satisfaction rates were reported with payment and physical work conditions. Conclusion: Quality of care was regarded as generally acceptable in terms of structure but with marked deficiency in human resources, and moderate deficiency of equipments and supplies. On the other hand, it was below average as perceived by clients and care providers. The study recommended conducting continuous quality assessment using different indicators and under the guidance of experts in this field.