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

Julie Kiguli¹, Elizabeth Ekirapa-Kiracho¹, Olico Okui¹, Aloysius Mutebi¹, Hayley MacGregor², George William Pariyo¹

¹Makerere University School of Public Health, Kampala, Uganda; ²Institute of Development Studies, Sussex, UK

Abstract: This paper examines the community’s perspectives and perceptions on quality of health care delivery in two Uganda districts. The paper addresses community concerns on service quality. It focuses on the poor because they are a vulnerable group and often bear a huge burden of disease. Community views were solicited and obtained using eight focus group discussions, six in-depth and 12 key informant interviews. User perceptions and definitions of the quality of health services depended on a number of variables related to technical competence, accessibility to services, interpersonal relations and presence of adequate drugs, supplies, staff, and facility amenities. Results indicate that service delivery to the poor in the general population is perceived to be of low quality. The factors that were mentioned as affecting the quality of services delivered were inadequate trained health workers, shortage of essential drugs, poor attitude of the health workers, and long distances to health facilities. This paper argues that there should be an improvement in the quality of health services with particular attention being paid to the poor. Despite wide focus on improvement of the existing infrastructure and donor funding, there is still low satisfaction with health services and poor perceived accessibility.

Keywords: quality, health care, poor, community, perceptions, utilization