title: Wait and consult times for primary healthcare services in central Mozambique: a time-motion study.
abstract: BACKGROUND
  We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times.
  
  
  METHODS
  We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors.
  
  
  RESULTS
  Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers.
  
  
  CONCLUSIONS
  The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness.
authors: Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.|Health Alliance International, Seattle, WA, USA; wagenaarb@gmail.com.
authors: Bradley H
authors: BH
authors: Wagenaar
authors: Health Alliance International, Seattle, WA, USA.|Department of Family Child Nursing, University of Washington, Seattle, WA, USA.
authors: Sarah
authors: S
authors: Gimbel
authors: Health Alliance International, Beira, Mozambique.|Beira Operations Research Center, Ministry of Health, Beira, Mozambique.
authors: Roxanne
authors: R
authors: Hoek
authors: Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.|Health Alliance International, Seattle, WA, USA.
authors: James
authors: J
authors: Pfeiffer
authors: Health Alliance International, Beira, Mozambique.
authors: Cathy
authors: C
authors: Michel
authors: Community Health Department, School of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
authors: Fatima
authors: F
authors: Cuembelo
authors: Health Alliance International, Beira, Mozambique.|Beira Operations Research Center, Ministry of Health, Beira, Mozambique.
authors: Titos
authors: T
authors: Quembo
authors: Health Alliance International, Beira, Mozambique.|Beira Operations Research Center, Ministry of Health, Beira, Mozambique.
authors: Pires
authors: P
authors: Afonso
authors: Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.|Health Alliance International, Seattle, WA, USA.
authors: Stephen
authors: S
authors: Gloyd
authors: Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.|Pangea Global AIDS, Oakland, CA, USA.
authors: Barrot H
authors: BH
authors: Lambdin
authors: Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.|Health Alliance International, Seattle, WA, USA.
authors: Mark A
authors: MA
authors: Micek
authors: Health Alliance International, Beira, Mozambique.|Beira Operations Research Center, Ministry of Health, Beira, Mozambique.
authors: Victoria
authors: V
authors: Porthé
authors: Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.|Health Alliance International, Seattle, WA, USA.
authors: Kenneth
authors: K
authors: Sherr
keywords: health professionals; health services research; healthcare allocation; maternal and child health; maternity services; primary health care; priority setting