Table 1 Primary Health Care Domains in the Questionnaire

RESOURCE ALLOCATION

   1. To what extent does the national government use differences in health needs as a basis for allocating money to different areas of the country?

() Very little

() To some extent

() To a major extent, but not the most important determinant

() The most important determinant

   Does the national government make special efforts to assure primary health care services to especially needy or underserved segments of the population (e.g., mobile health teams are organized to visit poor rural villages periodically)?

() Yes, generally

() To some extent only

() To a very small extent only

() No

ADEQUACY OF RESOURCES

   1. In your estimation, for what percentage of the population covered by these primary health care facilities is there an adequate supply of essential drugs a majority of the time (e.g. common antibiotics, pain relievers, other medicines identified as needed)?

() None

() 1–10%

() 11–20%

() 21–50%

() 51–75%

() 76–100%

   2. In your estimation, for what percentage of the population covered by these primary health care facilities is there sufficient basic equipment and/or supplies to fulfill their functions adequately (e.g., a working sterilizer, needles for vaccinations, other basic equipment?)

() None

() 1–10%

() 11–20%

() 21–50%

() 51–75%

() 76–100%

FIRST CONTACT

   1. Is consultation with a provider at the primary health care level required before someone is allowed to seek other care (e.g., in a hospital clinic, walk-in outpatient department, or specialist consultation) (except in cases of emergency)?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

COPAYMENT REQUIREMENTS

   1. What percentage of primary health care facilities requires people to pay out-of-pocket at the point of services?

() None

() 1–10%

() 11–20%

() 21–50%

() 51–75%

() 76–100%

LONGITUDINALITY

   1. Are patients generally seen by the same doctor or team each time they make a visit?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   2. Is there a policy to enroll people within a geographic area with a specific primary health care provider or provider group, by keeping patient lists or rosters?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   3. Is there a policy to ensure that primary health care facilities are regularly staffed by a physician or nurse?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

COMPREHENSIVENESS OF CARE

   To what extent do primary health care facilities or practices deliver each of the following services?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   1. Vaccinations for children

   2. Illnesses care for children

   3. Illnesses care for adults

   4. Illnesses care for the elderly

   5. Prenatal care/safe delivery

   6. Family planning services

   7. Care of sexually transmitted diseases

   8. Treatment of tuberculosis

   9. Treatment of minor injuries

   10. Counseling about alcohol and tobacco use

   11. Minor surgery

   12. Non-major mental health problems

   13. Care for chronic illness

   14. Health education

   15. Screening/treatment of parasitic disease(s)

   16. Nutrition program

   17. School-based services

COORDINATION

   1. In the primary health care system, is there a requirement to use a growth monitoring and vaccination record for all children seen in primary health care facilities?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   2. Is there a client-held record of vaccinations and growth monitoring?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   3. Is there a requirement to use a Prenatal Control Record?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   4. Is there a client-held record of prenatal care visits and test results for all women seen during pregnancy?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   5. Are there formal guidelines or common practice for transfer of information between the primary health care level and other levels of the health care system?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

FAMILY-CENTEREDNESS

   1. Are charts at primary health care facilities arranged by family (rather than by individual)?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

COMMUNITY ORIENTATION

   Does the health facility:

   1. Conduct surveys of patients to see if the services are meeting people's needs?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   2. Conduct surveys in the community to find about health problems they should know about?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   3. Ask family members to be on the Board of Directors or advisory committee?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

PROFESSIONAL PERSONNEL

   1. Do nurses serve as primary health care practitioners, that is, substitute for physicians?

() Definitely

() Mostly

() Mostly Not

() Definitely Not

   2. Indicate what type of health worker most commonly staffs most primary health care facilities (excluding hospital clinics)

○ Community health workers only

○ Community health workers and nurse(s)

○ Community health workers, nurse(s), and physician(s)

○ Nurse(s) only

○ Physician(s) and nurse(s)

○ Physician(s) only

   3. Do medical students at medical schools receive training in primary health care?

() Definitely

() Mostly

() Mostly Not

() Definitely Not