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Abstract
Access to primary healthcare services remains one of the most recurrent development problems for low- and middle-income countries, and Pakistan’s case reveals why access to a facility based on geographical location alone does not work. This study assesses an innovative delivery approach by the Helping Hand for Relief and Development organization, which provides curative, preventive, promotive, and maternal and child health services along with medicines, health education, screening and referral services to vulnerable communities in Rajanpur (Punjab), Mirpur Khas (Sindh) and Jafferabad (Balochistan). Using the cross-sectional data from 400 beneficiaries and multiple regression analysis, the study explores the role of five implementation dimensions – accessibility, quality of care, maternal and child health, health awareness, and use of services – together in affecting health outcomes and beneficiary satisfaction. The model explained a striking 77.7% of the variation in outcomes (R² = .777, adjusted R² = .774, F (5, 394) = 275.02, p < .001). Maternal and child healthcare emerged as by far the strongest driver (β = .623, p < .001), followed by service utilization (β = .245, p < .001) and, more modestly, quality of care (β = .056, p = .048). Although accessibility and community awareness showed high bivariate associations, they failed to have any significance after controlling for the other constructs, indicating that accessibility and health knowledge play an important role insofar as they lead to quality utilization of services and not in their own right. This research provides a new paradigm shift in the understanding of the relevance of mobile clinics: Mobile clinics should not be viewed as a last resort when there is a lack of health infrastructure but as a part of the primary healthcare platform whose success depends upon what takes place beyond its doors, especially for women and children.