CHAPTER ONE
INTRODUCTION
BACKGROUND OF THE STUDY
Primary health care is the foundation of a country’s health-care services. The health status of the country is determined by the quality of health care provided to the majority of the people, and it is the best predictor of the country’s degree of social progress. Primary health-care services must meet the following criteria: Efficient in terms of cost, procedures, and organization; readily accessible to individuals affected; acceptable to the community served; and at a reasonable cost. Health-care services should be provided in a way and language that is appropriate for the community and population served, and that is respectful of local traditions and customs, as well as at a cost that the population can pay. Increased patient satisfaction has been linked to better patient compliance, continuity of treatment, clinical outcomes, and service use and risk management. Patient satisfaction is thus a significant measure for evaluating and improving health-care services, as well as a key marker for the quality of health-care delivery. Patient satisfaction studies in health care began in the 1950s in the United States, with the first research attempting to predict patient satisfaction levels based on patient variables such as age, gender, and race (Apostle and Oder 1967;Bertakis et al. 1991). Another set of studies looked at health-care characteristics including nursing care, physician care, and so on to see what factors influence overall patient satisfaction (Ware et al. 1975; Ross et al. 1993; Dansky and Brannon 1996; Oswald et al. 1998). Veera Prasad, M.D.
Reliability is defined as the capacity to deliver the promised service consistently and precisely.
Responsiveness refers to a person’s readiness to assist patients and give prompt service.
Employees’ capacity to transmit trust and confidence, as well as their knowledge and civility.
Empathy is the ability to provide patients with compassionate, one-on-one attention.
Physical facilities, equipment, personal, and communication materials have a tangible look.
A study was conducted to determine which parts of a primary health-care experience, such as access, staff care, and physician care, are most important in patients’ responses to the services they receive. Physician care was shown to be the most influential of the three criteria, followed by staff care, while access had the least influence.
Patient satisfaction is influenced by a mixture of all of these aspects, which must be evaluated to ensure a favorable experience at the health-care facility.
Unfortunately, while several studies have been conducted in India to explore the parameters of patient satisfaction in tertiary care centers and large hospitals, studies of patient satisfaction at the primary care level, particularly GPs running solo clinics, which make up the majority of private primary care services, have received very little attention.
Client or patient satisfaction has become a critical component of health-care management techniques all around the world (Smith and Engolbracht, 2001). Because of the impact it has on a health facility’s success, customer views of health care quality are crucial.
Client satisfaction determines not only adherence to treatment and information about their sickness, but also the use of health services.
Turhal and colleagues (2002) stated that in the previous 20 years, the old “disease-centered” strategy to treating patients has shifted to a “patient-centered” approach. Patients now have more control over the treatment they receive and the ability to change the way care is delivered to them. Over the years, poor provider-client relationships have plagued Nigerian health care, causing customers and some health providers to express grave concerns. One of the Ministry of Health’s major difficulties is to provide high-quality, client-centered treatment (MOH). The problem of enhancing health care quality received substantial attention in 1989 during the Regional Directors’ conference as a result of concerns made by clients and health providers. Following the conference, enhancing health-care quality drew the attention of policymakers and health-care professional groups, and attempts were made to identify major concerns for improving health-care quality across the country.
STATEMENT OF PROBLEM
At all levels of care, health facilities are obligated to offer quality health care that satisfies the needs of their patients. However, this is not the case throughout the country. Clients’ concerns about the quality of service have grown as the provider-client relationship has deteriorated. Complaints from users regarding abusive and degrading treatment by health providers, as well as shortages of equipment, consumables supplies, and some necessary pharmaceuticals, are listed as some of the health services’ issues by the MOH (2007) in its national health strategy statement. Some health facilities are efficient, providing high-quality services and being attentive to their clients’ demands, according to the national health policy paper, but many are not.
The Nigerian Health Services recommends that health facilities conduct client satisfaction surveys at least twice a year to monitor and enhance the quality of treatment provided by health professionals in their facilities.
Despite the fact that some client satisfaction surveys have been completed, annual reports demonstrate that it has not been possible to conduct them twice a year. As a result, it’s unclear how long-lasting quality improvement initiatives have been throughout the year. Client satisfaction surveys have not been conducted in the country’s health centers and clinics. As a result, the level of professional care in these facilities is unknown, which is why this study on patient perception and satisfaction with healthcare professionals in primary health care facilities was conducted. Data on customer satisfaction is a significant tool for improving quality. As a way of gauging the quality of health care in Enugu, this study examines client perceptions and satisfaction with health care personnel. It not only assesses client perceptions and satisfaction with health-care services, but it also elicits which service areas are in need of improvement. It will also aid in bridging the gap between what clients expect and what they actually get. Obtaining feedback from clients on the present level of service will ensure that service delivery is focused on the client. This is important in order to maintain a high level of service quality.
OBJECTIVES OF THE STUDY
The overall goal of this research is to describe patient perceptions of and satisfaction with healthcare professionals in Enugu’s basic health care facilities. The following are the precise goals:
To describe and compare the perceived quality of treatment in Enugu at different levels of care.
To determine client satisfaction with health-care providers in health-care facilities.
To determine the predictors of customer satisfaction and perceptions of care quality in health care facilities.
RESEARCH QUESTIONS
The study was guided by the following research questions:
What is the perceived quality of care in Enugu at different levels of care?
What is the level of client satisfaction with the health-care providers in the hospitals?
What factors influence patients’ perceptions of care quality and satisfaction in health care facilities?
LIMITATION OF THE STUDY
The study’s key flaws were as follows:
On the premises of the health center, interviews and focus groups were held. Clients may be more likely to give higher evaluations because of fear of being victimized, even if they have been assured of confidentiality.
Interviewing caregivers of patients under the age of 15 instead of the patients themselves may not provide the most accurate picture because their perspectives may differ from the patients’.
Due to a lack of resources, just one health center and one clinic were tested.
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