Hi all story to tell In addition, (Atun, 2004) sought to determine, among other things, the

relationship between access to primary care and health outcomes, patient satisfaction and cost.
He reported that efficient healthcare systems produce better population health outcomes contrary
to increased mortality and morbidity from a poorly managed or organized healthcare system.
Furthermore, (Magnussen & Jolly, 2004) sought to compare comprehensive PHC to selective
healthcare as they affect global health. They concluded that only a primary-care system would
respond more equitably, appropriately, and effectively to basic health needs and address the
underlying social, economic, and political causes of poor health. (Bourke,2006) framed questions
around access to health care to understand the perspectives of consumers about their access to
healthcare. Bourke found that access to healthcare is a major factor in health outcomes and that
poor health status is associated with less or limited access to health services. Additionally,
Bourke reported that understanding consumer perspectives is critical to improving health
services, especially for rural populations.

2.5 EVALUATION OF PHC SERVICES

If PHC is to be effective and efficient, there is need for monitoring and evaluation. Monitoring
ensures interventions are implemented as planned and identifies specific problems as they arise.
It also allows continuous feedback (Baker, 2000). Monitoring PHC interventions means using
participatory approach to methodologically ensure that activities are carried out according to the
stipulated objectives of the intervention. Implementers use information generated to make
necessary changes for greater effectiveness and efficiency. On the other hand, (Green, 1992)
suggests that monitoring of health intervention is an important function of health planning during
implementation.

In PHC, evaluation is critical as it ensures that PHC services being offered are on the right track
with the desired effect and impact. Judgement of activities at every stage is hence based on valid,
accurate, and relevant information generated through monitoring and evaluation (Adindu, 2007).
Evaluation in PHC provides reliable information to guide present and future decisions and
actions, hence part of planning, and implementation processes rather than the activity that may or
may not be carried out. (Shield, 2003, p.33) in his article “quality indicators for primary care
mental health services” stated that; “effective PHC assessments helps in determining current
health realities, priorities, objectives”. Additionally, evaluation in PHC services is important at
the planning stage to understand current health situation, determine