2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Primary Health Care (PHC) reforms in Latin America increasingly emphasize prevention, continuity of care and integrated service delivery. However, an important challenge remains: institutional models frequently report strong preventive orientation at the policy level, while users continue to perceive barriers in access and proactive care. Understanding these gaps is critical for improving governance and effectiveness in PHC-centered systems. This study analyzes the degree of preventive orientation and organizational coherence of a university-based health care model in Colombia from the perspective of users, health professionals and institutional managers. Rather than focusing exclusively on PHC performance, the study explores how prevention policies are translated into real care experiences and how discrepancies between actors may reveal implementation weaknesses.

A cross-sectional analytical study was conducted at UISALUD, the health service provider and insurer of the Universidad Industrial de Santander. The Primary Care Assessment Tool – Ibero-American version (PCATIA) was applied to adult users (n=220), primary care professionals (n=13) and institutional managers (n=7). The instrument evaluates essential and derived PHC attributes using a Likert scale from 1 to 4, where values ≥3 indicate adequate orientation. Comparative analyses between perspectives were performed using descriptive statistics and inferential tests.

Findings revealed substantial differences between institutional and user perceptions of preventive care. Managers reported the highest overall PHC orientation (3.53/4), followed by users (3.15/4) and professionals (3.00/4). Accessibility emerged as the main structural weakness across all groups, particularly regarding same-day appointments and telephone access. The greatest discrepancy was identified in preventive orientation and anticipatory care, where users perceived substantially lower performance than professionals and managers. Community orientation also showed limited development among non-directive actors. These results suggest that the principal challenge is not the absence of preventive policies, but rather the limited operational translation of those policies into everyday patient experience. The study highlights the importance of incorporating multi-stakeholder evaluation frameworks into PHC governance and quality improvement processes. Additionally, it provides evidence from a university-based Latin American health system, a context still underrepresented in PHC assessment literature.

The findings support the need for stronger mechanisms of accountability, communication and service accessibility in preventive care models. Multi-perspective evaluation may serve as a strategic governance tool for aligning institutional objectives with patient-centered outcomes and strengthening preventive health system transformation.