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Kinyenje ES, Yahya TA, Degeh MM, German CC, Hokororo JC, Mohamed MA, Nassoro OA, Bahegwa RP, Msigwa YS, Ngowi RR, Marandu LE, Mwaisengela SM, Eliakimu ES. Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania. PLoS One 2022; 17:e0272321. [PMID: 35969601 PMCID: PMC9377608 DOI: 10.1371/journal.pone.0272321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Client service charter (CSC) provides information about what people can expect in a facility’s services; what is expected of clients and service providers. Tanzania implemented Star Rating Assessment (SRA) of primary health care (PHC) facilities in 2015/16 and 2017/18 using SRA tools with 12 service areas. This paper assesses the status of service area 7, namely client focus that checked if client was satisfied with services provided and implementation of CSC through three indicators–if: CSC was displayed; CSC was monitored; client feedback mechanism and complaints handling was in place.
Methods
We extracted and performed a cross-sectional secondary data analysis of data related to clients’ focus that are found in national SRA database of 2017/2018 using STATA version 15. Client satisfaction was regarded as dependent variable while facility characteristics plus three indicators of CSC as independent variables. Multivariate logistic regression with p-value of 5% and 95% confidence interval (CI) were applied.
Results
A total of 4,523 facilities met our inclusion criteria; 3,987 (88.2%) were dispensaries, 408 (9.0%) health centres and 128 (2.8%) hospitals. CSC was displayed in 69.1% facilities, monitored in 32.4% facilities, and 32.5% of the facilities had mechanisms for clients’ feedback and handling complaints. The overall prevalence of clients’ satisfaction was 72.8%. Clients’ satisfaction was strongly associated with all implementation indicators of CSC. Clients from urban-based facilities had 21% increased satisfaction compared rural-based facilities (AOR 1.21; 95%CI: 1.00–1.46); and clients from hospitals had 39% increased satisfaction compared to dispensaries (AOR 1.39; 95%CI: 1.10–1.77).
Conclusion
The implementation of CSC is low among Tanzanian PHC facilities. Clients are more satisfied if received healthcare services from facilities that display the charter, monitor its implementation, have mechanisms to obtain clients feedback and handle complaints. Clients’ satisfaction at PHC could be improved through adoption and implementation of CSC.
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Affiliation(s)
- Erick S. Kinyenje
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
- * E-mail:
| | - Talhiya A. Yahya
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Mbwana M. Degeh
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Chrisogone C. German
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Joseph C. Hokororo
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Mohamed A. Mohamed
- Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP), Dar es Salaam, Tanzania
- East Central and Southern Africa Health Community, Arusha, United Republic of Tanzania
| | - Omary A. Nassoro
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Radenta P. Bahegwa
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Yohanes S. Msigwa
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Ruth R. Ngowi
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Laura E. Marandu
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Syabo M. Mwaisengela
- Regional Administrative Secretary’s Office—Regional Health Management Team, Mtwara, Tanzania
| | - Eliudi S. Eliakimu
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
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Putturaj M, Krumeich A, Nuggehalli Srinivas P, Engel N, Criel B, Van Belle S. Crying baby gets the milk? The governmentality of grievance redressal for patient rights violations in Karnataka, India. BMJ Glob Health 2022; 7:bmjgh-2022-008626. [PMID: 35623644 PMCID: PMC9150157 DOI: 10.1136/bmjgh-2022-008626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background Patient rights aim to protect the dignity of healthcare-seeking individuals. Realisation of these rights is predicated on effective grievance redressal for the victims of patient rights violations. Methods We used a critical case (that yields the most information) of patient rights violations reported in Karnataka state (South India) to explore the power dynamics involved in resolving grievances raised by healthcare-seeking individuals. Using interviews, media reports and other documents pertaining to the case, we explored the ‘governmentality’ of grievance redressal for patient rights violations, that is, the interaction of micropractices and techniques of power employed by actors to govern the processes and outcomes. We also examined whether existing governmentality ensured procedural and substantive justice to care-seeking individuals. Results Collective action was necessary by the aggrieved women in terms of protests, media engagement, petitions and follow-up to ensure that the State accepted a complaint against a medical professional. Each institution, and especially the medical professional council, exercised its power by problematising the grievance in its own way which was distinct from the problematisation of the grievance by the collective. The State bureaucracy enacted its power by creating a maze of organisational units and by fragmenting the grievance redressal across various bureaucratic units. Conclusion There is a need for measures guaranteeing accountability, transparency, promptness, fairness, credibility and trustworthiness in the patient grievance redressal system. Governmentality as a framework enabled to study how subjects (care-seeking individuals) are rendered governable and resist dominant forces in the grievance redressal system for patient rights violations.
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Affiliation(s)
- Meena Putturaj
- Department of Health Ethics and Society, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands .,Health Equity Cluster, Institute of Public Health Bangalore, Bangalore, Karnataka, India.,Centre for Local Health Traditions and Policy, The University of Trans-Disciplinary Health Sciences and Technology, Bengaluru, Karnataka, India.,Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Anja Krumeich
- Department of Health Ethics and Society, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Nora Engel
- Department of Health Ethics and Society, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bart Criel
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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Roth-Cohen O, Levy S, Zigdon A. The Mediated Role of Credibility on Information Sources and Patient Awareness toward Patient Rights. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168628. [PMID: 34444377 PMCID: PMC8392652 DOI: 10.3390/ijerph18168628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 01/10/2023]
Abstract
Although patient rights are an important issue, this remains an understudied research area. Patients are unaware of their rights, lacking control of health care treatments they might deserve. This can contribute to sustaining inequality as well as failure in achieving welfare policy goals. Drawing on channel complementarity theory, the current study explored patients’ awareness toward their rights, and the credibility of information sources related to patient rights. In a web-based survey, 994 Israeli participants, suffering from chronic illness and using health services, were recruited. To examine the study’s theoretical framework and relationships among the constructs and test the hypotheses, a path analysis was conducted using Structural Equation Modeling. The research model depicts direct and indirect relationships between constructs, and the relevant coefficients. The results show a direct and positive interaction between information credibility and patient rights awareness (β = 0.10, p = 0.019). Information credibility partially mediates the relationship between public service information sources and patient rights awareness (bootstrap with 95% CI: 0.01–0.07; p = 0.015). The mass media information sources construct is directly and positively related to information credibility (β = 0.36, p = 0.000). Age was found as a moderator, indicating that information credibility is a factor only at lower ages. Therefore, patient rights should be systematically and reliably accessible in order to raise the awareness and trust of chronic patients regarding information about patient rights. Using planned health communication campaigns mainly via public service sources that are perceived as trustworthy can help contribute to approach patients more effectively and provide them with accessible and detailed information about their rights.
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Affiliation(s)
- Osnat Roth-Cohen
- School of Communication, Ariel University, Science Park, POB 3, Ariel 40700, Israel
- Correspondence:
| | - Shalom Levy
- Department of Economics and Business Administration, Ariel University, Science Park, POB 3, Ariel 40700, Israel;
| | - Avi Zigdon
- Department of Health Systems Management, School of Health Systems, Ariel University, Science Park, POB 3, Ariel 40700, Israel;
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