Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania

by Margaret E Kruk, Adanna Chukwuma, Godfrey Mbaruku et al.
Bulletin of the World Health Organisation 95(6), 389-480, 2017

11 pp. 592 kB

This study analysed factors affecting variations in the quality of antenatal and sick-child care in primary-care facilities in seven African countries, using service provision assessment surveys of health facilities in 2006–2014. Based on World Health Organization protocols, the authors created indices of process quality for antenatal care. Private facilities outperformed public facilities. Country differences were more influential in explaining variance in quality than all other factors combined. The authors conclude that the quality of two essential primary-care services for women and children was weak and varied across and within the countries. They observe that analysis of reasons for variations in quality could identify strategies for improving care.

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