Assessing Multi-Dimensional Performance of Primary Health Care Services at Puskesmas Welesi in Highland Papua Province

Abstract

Primary health care remains the cornerstone of equitable health systems, yet rural and remote regions face persistent challenges in delivering effective services. This study aimed to evaluate the performance of Puskesmas Welesi in Jayawijaya Regency, Highland Papua Province, by examining four key dimensions: access, quality, process, and system. A descriptive quantitative design was employed, using structured questionnaires administered to 25 community members, complemented by direct observation and literature review. Data were analyzed through descriptive statistics, producing mean scores for each dimension and an overall performance assessment. Results indicated that overall service delivery was rated as “fairly good” (mean score 58.6). Access to services emerged as the strongest dimension, with patients reporting relative ease of obtaining care and effective referral mechanisms. By contrast, technical quality was identified as the weakest area, reflecting concerns about diagnostic accuracy, shortages of essential medicines, and inconsistent health outcomes. Service processes and system management scored moderately, with respondents acknowledging provider attentiveness but noting difficulties in communication, complaint handling, and organizational efficiency. These findings align with national and international evidence showing that rural health facilities often succeed in maintaining accessibility but struggle with technical competence and systemic robustness. The study contributes to the limited empirical research on primary health care in Papua and underscores the importance of addressing disparities across dimensions rather than focusing on access alone. Strengthening workforce capacity, communication strategies, and management systems is essential for ensuring that accessible services translate into effective and equitable health outcomes.