Abstract
The aim of this research was to evaluate the effectiveness of the QA/I program in primary health care in Muscat Governorate, Oman. The aim was achieved through a set of objectives and through secondary and primary research into the current QA/I program in Muscat since its implementation in 2002. After a comprehensive review of the literatures, a theoretical framework was developed. The methodology was mixed methods i. e. qualitative and quantitative methods were used. Three phases were conducted to collect the data. Phase one explored all the secondary information exist about the QA/I program in PHC in Muscat Governorate. Phase two primary data were collected by the questionnaire survey. Phase three primary data were collected by using semi-structured interviews. The overall all response rate from the questionnaire survey was 91%. However, the analysis of all data found that factors affecting the effectiveness of the current system are: Human Resource Management: the research showed that intensive training is needed for QA/I program including training in patients’ safety, infection control, auditors’ refreshment trainings, awareness QA training, communication skills training. Capacity building is also needed at the QA area as well. The number of family physicians is not enough to run the PHC program at the current system; budgetary constraints (no budget is allocated for the QA program where a lot of activities are running in the system); QA Research needs to be strengthened and capacity building is also needed in this area; community involvement: community is involved at the Wilayat level (Districts); however, at the planning level and health centre QA technical committee the involvement of patients’ is not there. The community has to play a significant role in shaping the PHC services; documentation process is poor at the PHC and the health information system needs to be user-friendly and powerful in order to extract accurate information that aid for better decision making at the PHC level. A new National QA/I model is proposed by the end of this thesis. These findings indicate that a top management commitment is necessary to support the national QA system, capacity building is required, and a revision of the current PHC standards and policies and introduction of national accreditation system is advised. The study opens future research to explore and evaluate these factors in more depth to improve the quality of care at the primary health care in Oman.