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Low satisfaction of clients for the health service provision in West Amhara region, Ethiopia.

ABSTRACT: INTRODUCTION:Client satisfaction is a key indicator to measure quality of healthcare and provides information on the level of success forproviders whether client expectations and values are met. Although there are some institutional based studies done in Ethiopia, still client satisfaction in our settings is not well addressed. Thus, this study was aimed to assess client satisfaction level and identify the underlying factors of poor health service provision in West Amhara, Ethiopia. METHODS:A cross-sectional study design was conducted from July to August, 2013. A structured questionnaire was used to collect data from 422 outpatient diagnosis (OPD) service users. The data were entered into EPI Info version 3.5.2 and analyzed usingSPSS version 16. RESULTS:Among the 422 study participants, 234 (55.5%) males, the mean (±SD) age was 37.3 (±16.4) years. The overall satisfaction level of the study participants was 39.3%. Poor cleanliness of the facility, fewer service access provision, lack of prescribed drugs within the facility and longer waiting time to get the health care service wasreported by 73.2%, 67.8%, 65.6% and 59.2% of the clients respectively. Paying service users (AOR: 2.03, 95% CI: 1.22-3.39, P: 0.007), divorced clients (AOR: 4.26, 95% CI: 1.11-16.26, P: 0.034) and hospital users (AOR: 2.18, 95% CI: 1.29-3.69, P: 0.004) were more dissatisfied. CONCLUSIONS:Client satisfaction was lowin the health provision in West Amhara region. Expansion of health facilities in remote areas, maintaining continuous availability of prescribed drugs, improving cleanliness of health facilities, and fast health service provision are recommended to satisfy clients in the setting.

SUBMITTER: Derebe MM

PROVIDER: S-EPMC5493333 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Low satisfaction of clients for the health service provision in West Amhara region, Ethiopia.

Derebe Mulatu Melese MM Shiferaw Melashu Balew MB Ayalew Muluken Assefa MA

PloS one 20170630 6

<h4>Introduction</h4>Client satisfaction is a key indicator to measure quality of healthcare and provides information on the level of success forproviders whether client expectations and values are met. Although there are some institutional based studies done in Ethiopia, still client satisfaction in our settings is not well addressed. Thus, this study was aimed to assess client satisfaction level and identify the underlying factors of poor health service provision in West Amhara, Ethiopia.<h4>M ...[more]

PMID: 28665951

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Project description:IntroductionPostpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision.MethodsA facility-based cross-sectional study was conducted in Amhara region health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the facility. Multilevel analysis was done to see factors associated with outcome.ResultsA total of 197 health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (β = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (β = 0.97; 95% CI: 0.48, 1.47). Where the health facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the facility level (β = -0.47; 95%CI: -0.87, -0.07).ConclusionOur findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public health facility. The lowest knowledge score was noted among nurses, health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of health facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service.

Project description:BACKGROUND:The HEP was established decades ago to address preventive, promotive and selective curative services through Health Extension Workers (HEWs). However, knowledge and practice of HEWs on drug provision for childhood illnesses such as diarrhea, fever, and/or acute respiratory infection have not been well studied. This study aimed to assess the knowledge and practice of HEWs on drug provision for childhood illnesses. METHODS:An institutional-based cross-sectional study was conducted among 389 rural HEWs. The districts were selected by using simple random sampling technique, and all the HEWs in the districts were included in the study. Bivariable and multivariable logistic regressions were performed to see the association between knowledge and practice of HEWs on drug provision with the response variables. RESULTS:The study revealed that 57.5 and 66.8% of HEWs had good knowledge and practice on drug provision for childhood illnesses, respectively. Having college diploma (AOR?=?5.59; 95% CI: 1.94, 16.11), 7-9?years (AOR?=?2.7; 95% CI: 1.3, 5.5) and 10-12?years (AOR?=?2.7; 95% CI: 1.4, 5.4) of experiences, being supervised quarterly (AOR?=?0.24; 95% CI: 0.13, 0.47) and biannually (AOR?=?0.11; 95% CI: 0.04, 0.30), and having national guideline (AOR?=?0.22; 95% CI: 0.06, 0.90) were factors significantly associated with good knowledge. In addition, having college diploma (AOR =3.1; 95% CI: 1.1, 8.8), not receiving refreshment training (AOR?=?0.31; 95% CI: 0.11, 0.91), being supervised biannually (AOR?=?0.32, 95% CI: 0.13, 0.80), and not having national guideline (AOR?=?0.16, 95% CI: 0.04, 0.60) were factors significantly associated with good practice. CONCLUSION:The study indicated that a considerable number of HEWs had poor knowledge and practice on drug provision. Socio-demographic factors such as educational status, and work experience; and health systems and support related factors such as training, supervision, and availability of national guidelines, and training had a significant association with HEWs' knowledge and practice on drug provision. Therefore, designing appropriate strategy and providing refreshment training, and improving supervision and availability of national guidelines for HEWs might improve the knowledge and practice of HEWs on drug provision.

Project description:BACKGROUND:Despite progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal deaths. As facility-based childbirth and skilled-birth attendant at birth reduces maternal morbidity and mortality, the country has been implementing expansions in infrastructure during the past decades. Whether this phenomenal expansion in infrastructure and improvement in coverage of healthcare services matched with quality of maternal health service is not well investigated. This study assessed the quality of intrapartum care experienced by mothers at health centers in Jabi Tehinan district, North West Ethiopia. METHOD:An institution-linked community-based cross-sectional study was carried out from August to September 2018 to assess the quality of intrapartum care experienced by mothers during facility deliveries. Quantitative data were collected from 378 women who had uncomplicated births at health centers within 6?months preceding the survey and interviews were held with 25 women. The quantitative data were entered into SPSS for Windows versions 23 for analyses. Qualitative data were transcribed verbatim and data were used to substantiate the quantitative data. RESULT:The results indicated that 13% of mothers experienced good quality of intrapartum care services. About 49, 45, 31, and 25% of mothers respectively experienced good quality of human and physical resources; respect, dignity, and equity; emotional support; and cognition. Only 2% of mothers experienced good quality of services on the four dimensions and 15% did not experience good quality of services on neither of the dimensions. Mothers from rural areas and mothers who did not use ANC services for recent born children were found more likely to experience good quality of intrapartum care. Informants discussed poor quality of labor environment, lack of privacy, and poor client-provider communications at health facilities. CONCLUSION:The results indicated that the quality of intrapartum care experienced by mothers were minimal. The findings highlighted that efforts exerted to increase infrastructure and improve maternal health service coverage did not ensure quality maternal health services. Therefore, to increase the uptake of facility births and improved maternal health outcomes, stakeholders should make the health system humane, respectful, equitable, and responsive to mothers' concerns.

Project description:BackgroundMothers' satisfaction with care during childbirth is indicators of the quality care which affects skilled birth attendance. Negative client's experiences at health facilities cause them to delay or avoid seeking care, which highlights services providers should consider and act on the expectations and experiences of women and their families. Though there are few studies conducted in Ethiopia on maternal satisfaction with Labor and Delivery (LAD) services, there is no study conducted in the study area. Therefore the study aims to assess the mother's satisfaction with existing LAD services and associated factors at all levels of health care in the West Shewa zone.MethodsAn institution-based cross-sectional study was conducted at public health facilities in West Shewa zone, Central Ethiopia. A systematic sampling technique was used to select 560 respondents by using their delivery registration number and data were collected through face to face interview. Mothers were considered satisfied if they responded satisfied/very satisfied with 75% or more of the questions assessing satisfaction. Binary and multivariable logistic regression analysis was used to identify associated factors.ResultsThe overall proportion of mothers who were satisfied with the current LAD care services were 60.8%. The main areas of dissatisfaction were; accessibility and cleanness of toilets/shower 72.6%, overall cleanness of the facility/including waiting-area 40.1% and presence of support a person during birth 38.0%. The presence of cultural practices (AOR = 2.5), discussion on the place of delivery with health worker during ANC (AOR = 1.75), providers asks for consent before procedure (AOR = 2.77), encouraging companion to remain with mother (AOR = 2.22), never leave mother alone or unattended (AOR = 2.56), giving periodic updates on status and progress of labor (AOR = 2.04) and explaining what is being done and to expect during LAD (AOR = 2.20) were factors identified to be significantly associated with satisfaction on LAD services.ConclusionThe overall satisfaction of mothers with LAD services at public health facilities in the West-Shewa zone was relatively low. Presence of cultural practices, discussion on the place of delivery, asking for consent before the procedure, encouraging companion to remain with mothers and explaining what is being done were factors identified. Therefore, all stakeholders have to emphatically work on those identified factors to improve mothers' satisfaction with LAD services.

Dataset Information

Low satisfaction of clients for the health service provision in West Amhara region, Ethiopia.

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Low satisfaction of clients for the health service provision in West Amhara region, Ethiopia.

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