Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda

Figures & data

Figure 1 Community perspectives of the poor and nonpoor based on community responses from Iganga and Bushenyi districts.

Table 1 Perceptions about good and poor quality services

Good quality services	Poor quality services
Good sanitation in the facilities	Poor sanitation in the facilities
Sufficient health workers	Inadequate health workers
Sufficient drugs, supplies and equipment	Shortages of drugs, supplies and equipment
Short waiting time	Long waiting time
Counselling about preventive care	Inadequate/no counselling on preventive care
Services for the poor and elderly are available	Lack services for the poor and elderly
Good referral systems with transport	Poor referral system without transport
Polite and courteous health workers	Rude health workers

Table 2 Factors that affect the quality of services

Factors	Female FGD’s	Male FGD’s	Health workers	Vulnerable persons	Politicians and opinion leaders
Shortage of drugs	xx	x	xx	xxx	xxx
Poor attitude of health workers	xxx	xxx	x	xx	x
Inadequate health workers	x		xxx	xx	xxx
Long waiting time	x	x		xxx	x
Lack of amenities, supplies and equipment		x	xx	xx	xx
Poorly trained staff	x	x
Long distances to the health facility	x			x	xx
Poor remuneration of health workers		x	x	x

Notes: Data sourced from field findings from FGDs and KIs; xxx, Mentioned by many respondents; xx, Mentioned by a fair number of respondents; x, Mentioned by few respondents.

Table 3 How quality influences the utilization of health services

Attribute of quality	Group most affected	Effect on utilization
Negative attitudes of health workers	The poor, ethnic minorities	They decide not to seek services eg, antenatal and delivery services
		They don’t receive services such as drugs, proper examination
		They go to traditional providers/herbalists
Long waiting times	Those seeking care from public facilities especially those from lower social classes	Self medication
		They go to drug shops, private clinics or traditional healers
Long distances to health facilities	Pregnant women	Deliver with traditional birth attendants who are located closer to them
	The poor	Seek care from facilities that are closer irrespective of the quality of care provided
		Decide not to seek formal care
Poor infrastructure and hygiene	Those using public facilities	They go to private providers
Lack of equipment for theatre, drugs, and qualified staff	Both the poor and rich	Go to the facilities that have the equipment, drugs depending on severity of the condition. For minor illness private clinics, for severe illnesses government or PNFP hospitals
		Seek no care
		Self medication
Good interpersonal relations	Both the poor and rich	Use private facilities

Abbreviation: PNFP, private not-for-profit.