In conducting a comprehensive assessment of primary health care in Mendoza, Argentina, with a focus on noncommunicable diseases, we aimed to analyze patterns of health service use and disease management, user preferences for care and their perspectives on health system performance, and health care providers’ perspectives on health system performance.

The results revealed barriers to patients accessing services exacerbated by financial constraints, as well as significant gaps in patient experiences, system competence, and trust in the public health system.

One in 5 respondents to a population-based survey reported unmet health needs, providing valuable insights into users’ perspectives on health system performance. Limitations in access to mental health care were evident, reflecting wider systemic issues.

A consensus process produced actionable recommendations for policymakers, providing suggestions to guide future health system changes and research agendas based on evidence-based practices.

Using inclusive, equity-focused methods to assess health system performance ensures that the perspectives of underserved populations are addressed in the co-design process and highlights disparities in access to health care services.

In Argentina, the implementation of a national strategy to reduce the prevalence of noncommunicable diseases (NCDs) has been hampered by challenges at the provincial level. We aimed to design a new model of care for NCDs at the primary care level by conducting a multimodal system assessment and co-design of potential solutions in the province of Mendoza.

We carried out a mixed-methods study with 7 components: evaluation of patterns of care, patient focus groups, cross-sectional standardized population-based phone survey, an electronic cohort follow-up of patients with type 2 diabetes, in-depth interviews with stakeholders, a knowledge test for health care providers on chronic condition management, and a Delphi consensus to provide recommendations from stakeholders.

Focus group and in-depth interviews revealed access to primary health care for NCDs was associated with problems with long waiting times and time-consuming procedures for referral to laboratory tests, hospital care, and provision of medication. Mental health care services were particularly limited. Survey respondents (N=1,190) were predominantly covered through public (41%) or social security sectors (54%); 41% fell in the lowest income group. Contact with the health system was high (5.7 annual visits), but 19.7% reported unmet health care needs. Public sector providers perceived they provided high-quality care despite insufficient material and human resources. Within the social security sector, the main challenge was insufficient staff, particularly affecting mental health care. Health care providers showed a higher percentage of correct answers to depression-related questions, but worse results were seen in hypertension and diabetes care. Actions supported by evidence and expert agreement were identified for implementation to guide future system changes.

Our research highlights the potential for Argentina’s primary care system to initiate transformative, system-level changes aimed at improving health outcomes. We propose an innovative methodological assessment and co-design for improving primary care.

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