Primary health care facility performance assessment in Armenia

Purpose – The purpose of this study is to focus on the performance of select facilities in Lori and Shirak provinces in Armenia in Spring 2008. This is in response to the deterioration of the primary healthcare sector in Armenia. Design/methodology/approach – The performance assessment focused on the status of several performance indicators, both current and as recalled for 2006. The interviewer-administered questionnaire addressed access to care, provider relations with community and clients, environment, management, and primary and secondary prevention at the facilities. For each domain, a summative score that ranged from 0 to 3 was computed and a mean score for each facility derived. Findings – The project has had significant positive impact on facilities’ performance. Access to care scores increased from 2.0 in 2006 to 2.5 in 2008; provider relations with community improved from 1.1 to 1.4; environment scores improved from 1.3 to 1.9, facility management improved from 1.4 to 1.7; and prevention efforts increased from 1.3 to 1.9. The overall mean facility score increased from 1.4 to 1.8. Although the scores for small rural clinics increased, their scores were lower than the scores for other facility types. Originality/value – In the chronic absence of administrative surveillance data, this paper provides valuable information on the status of primary healthcare services in Armenian provinces. It demonstrates the value of interviewer-administered performance assessments in obtaining data across project sites when internal monitoring of progress is unavailable.