Introduction: Using clinical standard protocol at health institutions is the sine quo non to enforce, improve and control quality of health care. Primary health care clinical guideline (PHCG), the health centre clinical protocol, has been implementing since the last one year. So far, it has been implemented on 500 health centres—a total of 3714 health centres are currently available in Ethiopia. Since its implementation, one of the complaints, arising from health workers, to implement the guide is that it is time taking to use the guide and it would be very difficult to use the guideline in high load health centres.

Objective: To infer whether there is a time difference to treat a patient using and without the primary health care clinical guideline at the health centre level.

Method: Institutional based comparative cross-sectional study was conducted on 15 health centres—10 from Addis Ababa and 5 from Finfinnee zuria special zone. From each health centres at least 8 health worker patient interactions were observed. To compare the two arms (with PHCG vs without PHCG) 10 health centres were PHCG implementers and the remaining five were non-EPHCG implementers. To improve the validity of the study, health workers in the PHCG implementing health centres were communicated about the purpose of the study and told to use the guide strictly.

Result: A total of 136 health worker- patient interactions were observed. Ninety-two (67.6%) and 44(32.4%) interactions were observed from PHCG and Non-PHCG implementing health centres respectively. The median total time a patient took with a clinician (both clinical diagnosis and laboratory result interpretation and counselling time) was 8 minutes (Min and Max times were 3 and 35 min respectively). The mean clinical diagnosis and laboratory result interpretation and counselling times were 7.7 min and 1.7 min respectively.  Compared to Non-PHCG users, the median total time spent with patients in PHCG user health centres were 11.5 minutes: non-PHCG user health centre’s health worker patient interaction median total time was 8.0 minutes. The median total time spent at General outpatient department (OPD) and chronic illness clinic were 9 and 12 minutes. Only 52(38.3%) patients were sent to laboratory investigations.

Conclusion and recommendation: using a primary health care clinical guideline may take extra time to treat patients at health centres. The time taking may be more pronounced in treating chronic care clinic. Therefore, a rigorous human resource planning based on the health facilities case load is mandatory to efficiently utilize the available human resource at health centres as well as to improve quality of health care intended to achieve using the primary health care clinical guideline.

Key words: primary health care clinical guideline, clinical diagnosis time, clinical diagnosis time, laboratory investigation interpretation and counselling time