Perceptions of primary care assessment: a qualitative focus group study on the use of the qualiab tool

Abstract

Strengthening quality in Primary Health Care (PHC) requires evaluation instruments capable of supporting informed decision-making and improving organizational processes. The QualiAB, a self-assessment tool, has been adopted for this purpose; however, its effectiveness depends on stakeholders’ understanding, engagement, and practical use of its outputs. This study examined experiences with the implementation of QualiAB through focus groups conducted with PHC professionals, managers, and service users in the state of São Paulo, Brazil. Data were analyzed using thematic content analysis and guided by the COREQ checklist to ensure methodological rigor. Four analytical domains emerged: work process organization as a central attribute of quality; heterogeneity in the experience of applying the instrument; persistent challenges in providing care to vulnerable populations; and users’ perceptions regarding access, reception, and continuity of care. Findings suggest that although considered valuable, QualiAB remains underutilized in planning processes, indicating the need for capacity-building and technical refinement to enhance applicability.