Assessment of the Physical And Functional Aspects of Primary Health Care Centers

Background:  Adequate information and data are required for assessing the primary health care system’s performance. This study aimed to assess the physical and functional aspects of a sample of primary health care centers in Erbil, Iraqi Kurdistan Region. Methods: This quantitative cross-sectional study was conducted on eight randomly selected primary health care centers in Erbil, Iraqi Kurdistan Region. An assessment tool was designed to evaluate the selected centers' physical and functional performance, including physical infrastructure, workforce, preventive care, curative care, and support. We adopted a scoring system to measure performance based on several criteria for every aspect. Results: The overall quality of physical and functional aspects of the primary health care centers was low. Two primary health care centers were judged to perform well, and both were in Erbil city. The centers located in Erbil city performed best in most aspects, followed by the centers in areas around Erbil city. The primary concerns causing the poor performance of various aspects were poor building status and unsuitable waiting areas for the physical structure component, unavailability of diagnostic facilities for curative care, and shortage of family planning services and lack of female doctors for preventive care. Other major concerns were the low health staff ratio compared to administrative staff and the unavailability of training and continuing professional development opportunities. Conclusions: The primary health care centers performed poorly in most physical and functional aspects. This poor performance was particularly evident in the centers located outside Erbil city. The main components and issues affecting the performance were recognized and described.