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Subdistrict Community health centre, n Clinic, n Mobile, n Total, n Primary care headcount, n Raymond Mhlaba 1 36 4 41 396 759 Ngqushwa 0 22 3 25 184 645 Mnquma 1 28 3 32 539 295 Mbhashe 3 29 6 38 593 940 Great Kei 0 4 0 4 83 634 Amahlathi 0 25 7 32 308 385 Total 5 144 23 172 2 106 658 Core function Definition First contact access How easy is it for users to access primary care as the first place that they go when looking for assistance with a health issue. Continuity Informational continuity focuses on whether an up-to-date medical record is available when they attend primary care; relational continuity focuses on whether they develop a relationship of trust with and are known by their primary care provider. Coordination Parallel coordination focuses on coordination between teams within the PHC level of care; sequential coordination focuses on coordination between teams in different levels of care. Comprehensiveness Focuses on whether primary care covers the lifespan, the burden of disease, and includes health promotion, disease prevention, treatment, palliation, and rehabilitation. Person-centredness Focuses on whether care incorporates both the biomedical and users’ perspectives on the illness, and whether care focuses on the person and not just the disease. PCAT-SSA = sub-Saharan version of the Primary Care Assessment Tool. PHC = primary health care.
Characteristic n (%) Affiliation to the primary care facility (N = 385) Strong 297 (77.1) Moderate 81 (21.0) Weak 7 (1.8) How long have you been a patient at the facility? (N = 385) <1 year 13 (3.4) 1–2 years 43 (11.2) 3–4 years 63 (16.4) ≥5 years 264 (68.6) Unsure 2 (0.5) Why did you choose this facility? (N = 386) Because it is close to where I live or work 232 (60.1) Because I can afford the fees 3 (0.8) Because it offers good quality health care 247 (64.0) Because I am registered here and not allowed to go elsewhere 10 (2.6) Because my insurance covers me here 0 (0.0) Because I was referred here by another facility 6 (1.6) Other 8 (2.1) What is your home language? (N = 386) Xhosa 384 (99.5) Afrikaans 1 (0.3) English 1 (0.3) Which of the following best describes your work situation? (N = 386) Employed full time 45 (11.7) Employed part time 14 (3.6) Self-employed (informal) 23 (6.0) Self-employed (formal) 4 (1.0) Student 24 (6.2) Home maker 7 (1.8) Retired 115 (29.8) Unemployed 154 (39.9) Which of the following best describes your schooling? (N = 386) Did not complete primary school 68 (17.6) Completed primary school 39 (10.1) Did not complete high school 166 (43.0) Completed high school 85 (22.0) Completed tertiary education 26 (6.7) Refuse to answer 2 (0.5) Do you have piped water? (N = 386) Yes, inside my house 44 (11.4) Yes, inside my yard 175 (45.3) Yes, nearby 63 (16.3) No 104 (26.9) Do you have electricity in your home? (N = 384) Yes 364 (94.8) Which of the following best describes your home? (N = 384) Structure made of brick or concrete blocks 284 (74.0) Structure made of wood, zinc, or mud 100 (26.0) Refuse 1 (0.3) Is anyone employed in your household? (N = 385) Yes 193 (50.1) Do you have water-borne sewage (i.e. a toilet)? (N = 385) Yes, inside my house 51 (13.2) Yes, inside my yard 190 (49.4) Yes, nearby 2 (0.5) No 141 (36.6) Would you say your health status is: (N = 385) Excellent 51 (13.2) Very good 135 (35.1) Good 95 (24.7) Fair 94 (24.4) Poor 10 (2.6) Do you have a chronic condition? (N = 382) Yes 88 (23.0) Function Median score (IQR) Scoring ≥3,
n (%)Interpretation Primary care (N = 333) 3.3 (3.2–3.5) 308 (92.5) Acceptable Access (N = 385) 1.7 (1.0–2.9) 96 (24.9) Poor Utilisation (N = 384) 4.0 (4.0–4.0) 384 (100.0) Good Comprehensiveness (N = 344) 3.3 (2.9–3.6) 259 (75.3) Acceptable Continuity (N = 379) 3.2 (3.1–3.6) 332 (87.6) Acceptable Person-centeredness (N = 380) 4.0 (4.0–4.0) 368 (96.8) Good Coordination (N = 386) 4.0 (4.0–4.0) 366 (94.8) Good IQR = interquartile range.
- Table 5. Associations between subdistricts, health status, and sociodemographic factors and mean primary care score
Variable Mean primary care score (95% CI) P value Subdistrict Mnquma 3.3 (3.2 to 3.3) <0.001 Mbhashe 3.5 (3.4 to 3.5) Amahlathi 3.3 (3.2 to 3.3) Ngqushwa 3.4 (3.3 to 3.5) Great Kei 3.1 (3.0 to 3.2) Raymond Mhlaba 3.4 (3.3 to 3.4) Gender Man 3.3 0.103 Woman 3.4 Mean difference -0.1 (-0.1 to 0.0) Education Did not complete primary school 3.4 (3.3 to 3.5) 0.323 Completed primary school 3.4 (3.3 to 3.5) Did not complete secondary school 3.3 (3.3 to 3.4) Completed secondary school 3.4 (3.3 to 3.4) Completed tertiary education 3.3 (3.2 to 3.4) Type of house Structure made of brick or concrete blocks 3.4 0.018 Structure made of wood, zinc, or mud 3.3 Mean difference 0.1 (0.0 to 0.1) Employment in household Yes 3.3 0.459 No 3.4 Mean difference -0.0 (-0.1 to 0.0) Employment of patient Employed full time 3.3 (3.3 to 3.3) 0.014 Employed part time 3.3 (3.1 to 3.5) Self-employed (informal) 3.4 (3.2 to 3.5) Self-employed (formal) 3.5 (3.2 to 3.7) Student 3.2 (3.0 to 3.3) Home maker 3.4 (3.2 to 3.6) Retired 3.3 (3.3 to 3.4) Unemployed 3.4 (3.3 to 3.5) Piped water Yes, inside house 3.2 (3.1 to 3.3) <0.001 Yes, in yard 3.4 (3.4 to 3.5) Yes, nearby 3.4 (3.3 to 3.5) No 3.2 (3.2 to 3.3) Electricity Yes 3.3 0.308 No 3.3 Mean difference 0.1 (-0.1 to 0.2) Toilet Yes, inside house 3.2 (3.1 to 3.3) Yes, in yard 3.5 (3.4 to 3.5) Yes, nearby 3.9 (3.3 to 4.5) No 3.2 (3.2 to 3.3) Health status Excellent 3.4 (3.3 to 3.4) <0.001 Very good 3.5 (3.4 to 3.5) Good 3.3 (3.2 to 3.3) Fair 3.3 (3.2 to 3.3) Poor 3.3 (3.1 to 3.4) Chronic condition Yes 3.2 <0.001 No 3.4 Mean difference -0.2 (-0.3 to -0.2) Mean score Median score Core function South Africa Kenya Uganda Amathole Primary care 3.1 2.6 3.0 3.3 Access 2.5 2.3 2.6 1.7 Utilisation 3.4 3.1 3.0 4.0 Comprehensiveness 3.2 2.1 3.0 3.3 Continuity 2.9 2.8 2.6 3.2 Person-centredness — — 3.5 4.0 Coordination 3.3 2.9 2.3 4.0
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