Determinants of the quality of healthcare services among general hospitals in Uganda

Abstract

Healthcare service delivery in Uganda faces numerous challenges, particularly in general hospitals where quality is often compromised. This study aimed to identify the determinants of quality of healthcare in Ugandan health facilities, focusing on the effects of facility ownership, type, and location. While previous research has established that general healthcare services in low-income countries frequently experience resource constraints, limited research has explored how different ownership structures and facility types of impact service quality within the Ugandan context. This study addressed this gap by analyzing secondary data from the World Bank Service Delivery Indicators Health Survey 2013, which included a sample of 394 health facilities, with an emphasis on general hospitals in Kampala. The primary research question sought to understand how ownership type, facility type, and location influence the quality of care provided. The study examines the determinants of the quality of healthcare service among general hospitals in Uganda, with a focus on the effects of health facility location, ownership, and type. A cross-sectional study design was employed using secondary data from the World Bank Service Delivery Indicators Health Survey 2013. The sample included 394 health facilities, with a specific emphasis on general hospitals in Kampala. Data collected between June and October 2013 was analyzed to understand how various factors impact the quality of healthcare services. The findings revealed that ownership type significantly influenced the quality of care, with faith-based and NGO/non-profit health facilities more likely to provide higher-quality services compared to general hospitals. Ambulance availability also played a crucial role in predicting moderate and high-quality care, while rural health facilities exhibited poorer service delivery compared to their urban counterparts. Despite the overall poor service delivery in rural areas, health centers and general hospitals demonstrated higher proportions of high-quality care relative to other facility types. Based on these findings, it is recommended that the government strengthen partnerships with NGOs and faith-based organizations to improve healthcare quality through additional resources, training, and expertise. Further investment in essential infrastructure, such as ambulance services, is crucial for timely patient care. Continuous healthcare provider training and regular assessments for quality control are also necessary to ensure sustained improvements in service delivery.