Assessing the core functions of primary care in the Otjozondjupa region, Namibia

Background: The World Health Organization’s measurement framework identifies five core functions (access, continuity, coordination, comprehensiveness, and person-centredness) as key aspects of high-quality primary care. Standards for Namibian primary care were set in 2021, but the performance of primary care core functions has yet to be measured. The aim was to measure the performance of primary care core functions in the Otjozondjupa region, Namibia. Methods: A descriptive cross-sectional survey used the primary care assessment tool to collect data from 408 randomly selected patients and 10 facilities. Data were collected in the REDCap mobile App and analysed using the Statistical Package for Social Sciences (SPSS), version 27. Results: The overall median primary care score was 2.6 (interquartile range [IQR] 2.5–2.9), which was borderline acceptable. The utilisation score of 3 (IQR 3.0–3.7), person-centredness score of 3 (IQR 2.8–3.9), and coordination score of 3 (IQR 2.7–3.3) were in the acceptable range. Comprehensiveness (2.7, IQR 2.5–2.9) and continuity (2.5, IQR 2.1–2.9) scored borderline acceptable. Access was rated very poor at 1.0 (IQR 1.0–2.2). Overall, 56% of users reported a strong affiliation with their facility. There was a significantly positive correlation between integration and continuity (r = 0.310, p < 0.001). Comprehensiveness (r = −0.326, p < 0.001) and coordination (r = −0.203, p < 0.001) were negatively correlated with integration. Conclusion: Primary care performance was borderline acceptable, and none of the domains was rated as ‘good’. There is a need to improve all the core functions, particularly access. Contribution: This study is the first to evaluate the core functions of primary care in the Namibian context.