Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

• Main Authors: Bradley H. Wagenaar, Sarah Gimbel, Roxanne Hoek, James Pfeiffer, Cathy Michel, Fatima Cuembelo, Titos Quembo, Pires Afonso, Stephen Gloyd, Barrot H. Lambdin, Mark A. Micek, Victoria Porthé, Kenneth Sherr
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2016-08-01
• Series: Global Health Action
• Subjects: health services research; maternal and child health; maternity services; primary health care; priority setting; healthcare allocation; health professionals
• Online Access: http://www.globalhealthaction.net/index.php/gha/article/view/31980/pdf_323

Background: We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. Design: We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. Results: Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. Discussion: The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness.