Identifying gaps in primary care services: reaching the ‘unreached’

Equity can be considered in terms of potential and realised access. The availability and organisation of health services and the help-seeking characteristics of the population determine potential access. Realised access relies upon the utilisation of services that are acceptable to the consumer and fulfil local needs. As such, under-utilisation may arise from poor service quality, cultural insensitivity, or inadequate geographical allocation of services. The PROGRESS-Plus tool (Box) summarises the ‘social determinants and factors’ that may impact upon a person’s potential to realise access to health services.