ArticleBMC family practice2021
A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users.
Article in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
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- Access to essential medicines during the Sudanese civil war: a cross-sectional study.International journal for equity in health · 2025Article
- Healthcare workers' perception of quality of care rendered to people living with HIV and non-communicable diseases at an urban district hospital in KwaZulu Natal, South Africa: a mixed mode study.BMC health services research · 2025Article
- Trials for LLM-supported clinical decisions in African primary healthcare.Nature medicine · 2025Article
- Factors Influencing Primary Healthcare System in the Achievement of Universal Health Coverage in the WHO-AFRO Region: An Integrative Review.Public health challenges · 2025Review
- The legal needs of people receiving palliative care in Uganda: A multi-method assessment to advance universal health coverage.Palliative care and social practice · 2025Article
- Barriers and facilitators of primary care management of type II diabetes mellitus in the West African sub-region: A scoping review.PLOS global public health · 2025Article
- Conceptualisation and Role of Market Access in Pharmaceutical Industry: A Scoping Review.Journal of market access & health policy · 2024Article
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- Do private health providers help achieve Universal Health Coverage? A scoping review of the evidence from low-income countries.Health policy and planning · 2023Article
- The cost of illness for childhood clinical pneumonia and invasive pneumococcal disease in Nigeria.BMJ global health · 2022Article
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- Integrated healthcare services for HIV, diabetes mellitus and hypertension in selected health facilities in Kampala and Wakiso districts, Uganda: A qualitative methods study.PLOS global public health · 2022Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundUniversal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa.
methodsA qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four 'As' of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes.
resultsAccess to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites.
conclusionsThere was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.
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