Client satisfaction with abortion care service and its associated factors among women in Ethiopia: a systematic review and meta-analysis

BACKGROUND

The client's satisfaction after abortion care is the key to sustaining abortion care and increasing the health status of those who had complications from abortion. Nevertheless, research conducted in Ethiopia stated that the major problem is the need for post-abortion care for females. One of the ways to improve the qualities involved in post abortion care and decrease the mortality and morbidity rates caused by unsafe abortion is by ensuring client satisfaction with abortion care. Strategy making and policy formulation based on systematic review take on the highest priority in developing countries. However, although some independent studies had been carried out in Ethiopia, their findings might not have been representative and conclusive. The main purpose of this systematic review and meta-analysis article is to establish the proportion of abortion clients who are satisfied with their abortion care and the factors that contribute to such satisfaction among clients in Ethiopia.

METHODS AND MATERIALS

Only published articles were considered in this review. The main databases included Medline/Pubmed, Web of Science, Embase, Cinael, Med Nar, Google Scholar, Scopus, the Ethiopian University Repository Online, and the Cochrane Library. The review includes cross-sectional studies that meet the requirements and were written in English. A random effects model was used to calculate the pooled prevalence of client satisfaction with abortion care. The study heterogeneity was tested using Cochrane Q-Static and I2. Publication bias was checked using the Eggers test and funnel plot. PRISMA was used to select and direct the selection of articles for this review. Statistical analyses were conducted using STATA version 14.

RESULT

A review of ten studies comprised 2740 women. In summary, the pooled prevalence of client's satisfaction with abortion care in Ethiopia was 56.13% [95% CI (42.35; 69.91), I2 = 99.1%, p < 0.001]. In terms of subgroup analysis, Gambella had the highest prevalence of client satisfaction with abortion care at 87.40% [95% CI: 82.38 and 91.82]. However, Amhara had the lowest: 25.00% [95% CI: 21.59, 28.41]. The review also found that client satisfaction with abortion care had a statistical correlation with the type of procedure [OR: 0.25, CI [0.07, 0.42], I2: 76.9%, p-value: 0.041] and the participant's education level [OR: 0.29, CI [0.09, 0.48], I2: 80.4%, p-value: 0.006].

CONCLUSION

This review found that 56% of Ethiopian women were satisfied with their abortion care. Since this requires a boost to the quality of abortion care in the health facility, understanding women's expectations and perceptions, training of health care providers, and strict monitoring of the quality of abortion care services by stakeholders like the Ethiopian government, non-governmental organizations, and high-level management of the health facility would help to improve the level of women's satisfaction with abortion care. Those factors, namely, the type of method to use for the patient and women's educational level, should be changed through improving awareness among the patients about what procedure to conduct and the health education provided to women about abortion care.

Client satisfaction and contributing factors towards sexual and reproductive health services delivery system among youth at Family Guidance Association of north Ethiopia (FGAE) clinics, 2023: mixed method study

BACKGROUND

The Family Guidance Association of Ethiopia (FGAE) operates as a non-governmental organization dedicated to offering family planning and reproductive health services to the Ethiopian population. The gap in the study regarding client satisfaction and contributing factors towards sexual and reproductive health services for youth at FGAE clinics highlights the need for a comprehensive investigation to fill this void. By conducting a mixed-method study, this research aims to provide a holistic understanding of the factors influencing client satisfaction in the delivery of sexual and reproductive health services to youth at FGAE clinics. The added value of this study lies in its potential to offer valuable insights and recommendations for improving service delivery systems and enhancing client satisfaction levels, ultimately contributing to the overall well-being and health outcomes of youth in North Ethiopia. Therefore study aimed to asses Client Satisfaction and Contributing Factors towards in sexual and reproductive health services delivery system among youth at Family Guidance Association of North Ethiopia (FGAE) Clinics, 2023.

METHOD

The study was conducted within the clinics of the Family Guidance Association of Ethiopia (FGAE), spanning Dessie, Kombolcha, and Woldia city administrations, involving a participant cohort of 416 clients. Facility-based concurrent type mixed method study design both quantitative and qualitative techniques were applied. Quantitative research employed a simple random sampling technique and conversely, the qualitative study utilized a heterogeneous type of purposive sampling strategy to recruit participants The collected data underwent a rigorous process of entry, cleaning, and coding using Epi-Data 4.6 software, followed by analysis in STATA V17. Descriptive statistics and binary logistic regression were employed to highlight the impact of independent variables on the dependent variable. A more comprehensive examination was provided through multivariable logistic regression. Crude and adjusted odds ratios, along with a 95% confidence interval, were computed, with significance set at a p-value ≤ 0.05.

RESULT

Nearly more than half of the clients 194 (47.8%) came to receive family planning services followed by maternal and child health 107 (26.4%). Sixty patients (14.8%) didn't receive all the services they wanted or came for. Half of the participants 30 (50%) raised the unavailability of the service as a reason for not taking the service followed by not having enough time in the clinic 12 (20%). About 65.52% (60.74-70.00%) of the participants were satisfied with the Sexual and Reproductive Health services provided by the clinics of FGAE in northeast Ethiopia. Clients in the age group of 25-34 (AOR = 2.04; 95%CI: 1.11-3.72). Clients who had primary and secondary education (AOR = 2.49; 95%CI: 1.03-6.02) and (AOR = 3.05; 95%CI: 1.25-7.49) respectively. Clients who responded that physicians show respect (AOR = 5.59; 95%CI: 1.89-16.49). clients who received an explanation about the side effects of the utilized methods and follow-up dates (AOR = 4.59;95%CI:1.68-12.53) and (AOR = 2.89;95%CI:1.53-5.49) respectively.

CONCLUSION

The proportion of client satisfaction with Client Satisfaction in the Services delivery system at Family Guidance Association of Ethiopia (FGAE) Clinics was low as compared to the previous study. Age group 25-34 years, primary and secondary education, showing respect, explaining side-effects and follow-up visits were significant associated factors of client service satisfaction. Enhancing service delivery at Family Guidance Association of Ethiopia (FGAE) Clinics by targeting specific areas identified in the study. Strategies should focus on improving communication regarding side effects, ensuring respectful interactions, and prioritizing follow-up visits, particularly for clients aged 25-34 with primary and secondary education backgrounds.

Maternal satisfaction with delivery service and associated factors among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia

BACKGROUND

Maternal satisfaction during delivery services is considered an important indicator of the quality of healthcare in a hospital setting and determines the uptake of services during subsequent pregnancies. However, there is limited information on the magnitude of women's satisfaction during delivery services in the study area. Thus, this study aimed to assess factors associated with maternal satisfaction with delivery services among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia.

METHOD

A facility-based cross-sectional study was conducted at public hospitals in Guji Zone from December 1, 2020, to January 30, 2021. Two hundred forty-nine women who gave birth at public hospitals were recruited by a systematic random sampling technique. The collected data were entered into the Epi Info 7 software and then exported to SPSS Version 26 for analysis. A logistic regression model was employed to identify the association between independent variables and maternal satisfaction during delivery services. A P-value less than 0.05 and an Adjusted Odds Ratio with 95% CI was computed to determine the strength of the association between these variables.

RESULT

In this study, 138(55.4%), 95% CI (49.1-61.7) women were satisfied with delivery. Mothers who delivered through cesarean section (AOR = 2.92, 95% CI: 1.34-6.33), privacy assured (AOR = 3.14, 95% CI: 1.76-5.59), shorter duration of labor (AOR = 2.82, 95% CI: 1.64-4.62), waiting time ≤ 30 min (AOR = 5.15,95% CI:1.99-13.32) and normal fetal outcome (AOR = 2.63, 95% CI:1.42-4.85) were associated with mothers satisfaction with delivery care services.

CONCLUSION

The overall magnitude of women's satisfaction with delivery services is low, which is below the national client satisfaction target of ≥ 85%. Factors such as mode of delivery, assured privacy, short duration of labor, waiting time ≤ 30 min, and good fetal outcome were significantly associated with women's satisfaction with delivery services. Therefore, healthcare providers should provide better management during intrapartum childbirth or emergency obstetric care to improve fetal outcomes during delivery services. In addition, health facility managers should avail infrastructure that helps to maintain the privacy of women who give birth in the facility.

Client satisfaction with antiretroviral treatment services in South Ethiopian public health facilities: an institution-based cross-sectional survey

BACKGROUND

HIV/AIDS remains the leading cause of morbidity and mortality worldwide. Moreover, sub-Saharan countries, including Ethiopia, are highly affected by HIV/AIDS pandemic. Ethiopia's government has been working on a comprehensive HIV care and treatment programme, including antiretroviral therapy. However, evaluating client satisfaction with antiretroviral treatment services is not well studied.

OBJECTIVES

This study aimed to assess client satisfaction and associated factors with antiretroviral treatment services provided at public health facilities of Wolaita zone, South Ethiopia.

METHODS

A facility-based cross-sectional study involved 605 randomly selected clients using ART services from six public health facilities in Southern Ethiopia. A multivariate regression model was used to see an association between independent variables and the outcome variable. The odds ratio with 95% CI was computed to determine the presence and strength of the association.

RESULTS

Four hundred twenty-eight (70.7%) clients were satisfied with an overall antiretroviral treatment service, which included significant variations ranging from 21.1% to 90.0% among health facilities. Sex [AOR = 1.91; 95% CI = 1.10-3.29], employment [AOR = 13.04; 95% CI = 4.34-39.22], clients' perception of the availability of prescribed laboratory services [AOR = 2.56; 95% CI = 1.42-4.63], availability of prescribed drugs [AOR = 6.26; 95% CI = 3.40-11.52] and cleanliness of toilet in the facility [AOR = 2.83; 95% CI = 1.56-5.14] were factors associated with client satisfaction with antiretroviral treatment services.

CONCLUSION

The overall client satisfaction with antiretroviral treatment service was lower than the national target of 85%, with a marked difference among facilities. Sex, occupational status, availability of comprehensive laboratory services, standard drugs, and cleanliness toilets in the facility were factors associated with client satisfaction with antiretroviral treatment services. Sex-sensitive services needed to address and sustained availability of laboratory services and medicine recommended.

Quality of family planning services and associated factors among reproductive age women attending family planning unit at public health facilities in Dire Dawa, Eastern Ethiopia, 2021

INTRODUCTION

Improving the quality of care has been a necessary goal for family planning programs worldwide. Even though extensive work has been done, the contraceptive prevalence rate is still low (41% in Ethiopia, 30.5% in Dire Dawa) and the unmet need for contraception is high (26%) in Ethiopia. Moreover, quality of care in family planning services has an important role in increasing coverage of services and program sustainability. Therefore, the objective of this study was to assess quality of family planning services and associated factors among reproductive age women attending family planning unit in public health facilities in Dire Dawa, Eastern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among reproductive-age women attending a family planning unit in Dire Dawa, Eastern Ethiopia, from September 1-30/2021. A total of 576 clients were selected by systematic random sampling and interviewed using a pre-tested structured questionnaire. SPSS version 24 was used to analyze the data, which included descriptive statistics, bi-variable and multivariable logistic regression analyses. To determine the presence of an association between dependent and independent variables, AOR, P-value 0.05, and 95% CI were used.

RESULTS

A total of 576 clients participated in the study and provided a response rate of 99%. The overall satisfaction of clients with FP services was 79%[95% CI:75.2%, 82.9%]. Having primary education (AOR = 2.11, 95% CI(1.11-4.24), convenient facility opening hours (AOR = 3.13, 95% CI (2.12-5.75), maintaining privacy (AOR = 4.1, 95% CI(2.50-8.12), demonstrating how to use F/P method (AOR = 1.98, 95% CI (1.01-5.20), and discussing F/P issues with husbands (AOR = 5.05, 95% CI: 3.33-7.64) were positively significantly associated with client satisfaction.

CONCLUSION AND RECOMMENDATION

This study revealed that about four-fifth of the clients was satisfied with the service they received. Clients' education, facility opening hour, maintained privacy, discussion with husband, and demonstration of how to use the methods were associated with client satisfaction. Therefore, health facility heads should improve facility opening hour. Health care providers should maintain client privacy every time, and should consistently utilize information, education, and communication materials during consultation sessions by giving more attention to client who has no education. Partner's discussion on family planning issues should also be encouraged.

Prevalence and associated factors of client satisfaction with family planning service among family planning users in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Considering the importance of client satisfaction in the quality of family planning services, a regular evaluation should be carried out. Several studies have been conducted in Ethiopia, but so far there were no pooled estimates of the prevalence of customer satisfaction with family planning services in the country. Therefore, this systematic review and meta-analysis was intended to estimate the pooled prevalence of client satisfaction with Ethiopian family planning services in Ethiopia. The findings of the review can be used to develop strategies and draft policies in the country.

METHODS AND MATERIALS

This review included articles published only in Ethiopia. The main databases were Medline/PubMed, Web of Science, Google Scholar, Scopus, Ethiopian University Repository Online, and Cochrane Library. Cross-sectional studies conducted in English and meeting the eligibility criteria were included in the review. A random-effects meta-analysis was performed. Data extraction and analysis were performed using Microsoft Excel and STATA version 14 software, respectively.

RESULT

The pooled prevalence of customer satisfaction with family planning services in Ethiopia was 56.78% [(95% CI (49.99, 63.56); I² = 96.2%, p < 0.001]. Waiting time > 30 min [OR = 0.2, 95% CI (0.1-0.29), I² = 75.0%, p < 0.001], privacy maintained [OR = 5.46, 95% CI (1.43-20.9), I² = 95.8%, p < 0.001], education status [OR = 0.47], 95% CI (0.22-0.98), I² = 87.4%, p < 0.001] was significant in client satisfaction related to family planning services.

CONCLUSION

According to this review, client satisfaction with family planning services in Ethiopia was 56.78%. In addition, waiting time, women's educational level, and respect for privacy were identified as factors that both positively and negatively impact women's satisfaction with family planning services. Decisive action, such as educational intervention, continued monitoring and evaluation of family planning services, and arranging training for providers, is required to address identified issues and ensure higher levels of family satisfaction and utilization. This finding is important for shaping strategic policies and improving the quality of family planning services. This finding is important for designing strategic policy and increasing the quality of family planning services.

Satisfaction with comprehensive emergency obstetric and newborn care services and associated factors among clients in University of Gondar Specialized Hospital, Northwest Ethiopia: A cross-sectional study

Objective

Emergency obstetric and newborn care services treat 70-80% of maternal deaths. This study aimed to assess satisfaction with comprehensive emergency obstetric and newborn care (CEmONC) services and associated factors among clients in the University of Gondar Specialized Hospital.

Methods

Institution-based cross-sectional study was conducted on 404 participants using a systematic random sampling method. The study was conducted from March 5 to May 5, 2020, using interviewer-administered structured questionnaires. Binary logistic regression was used to find the association between independent variables and client satisfaction. The level of statistical significance was declared at a p value less than 0.05.

Results

The overall clients' satisfaction with CEmONC services was 65.1% (95% confidence interval (CI): 60.9-69.8). Clients' satisfaction was affected by women who had antenatal care (ANC) of three visits (adjusted odds ratio (AOR): 6.5; 95%, CI: 2.04-20.8), women waited less than 15 min (AOR: 4.15, 95% CI: 1.9-9.06), mothers stayed ⩽1 day (AOR: 0.28, 95% CI: 0.09-0.9) and 2-3 days (AOR: 0.98, 95% CI: 0.1-0.69), obtaining a welcoming environment (AOR: 4.6, 95% CI: 2.15-9.88), and getting providers explanation of examinations (AOR: 3.3, 95% CI: 1.97-5.52).

Conclusion

The observed clients' satisfaction with CEmONC services was suboptimal. Having ANC of three visits, waiting less than 15 min, duration of stay, obtaining a welcoming environment, and an explanation of providers' examination were the identified factors of client's satisfaction. Therefore, hospital managers and health professionals should work on the identified factors to increase the client's satisfaction with these services.

Profile, Quality of Life and the Client Satisfaction of Beneficiaries Registered under Rashtriya Bal Swasthya Karyakram (RBSK) at an Urban Primary Health Centre, Ahmedabad: A Retrospective Cohort Study

Background

Under Rashtriya Bal Swasthya Karyakram (RBSK), children (0-18 years) are screened for a spectrum of 30 health conditions, categorized under 4D's namely defect (birth), disease (chronic), deficiency disorders, and developmental delay, and referred for treatment at higher centers. The aim of this study is to document demographic, clinical profile of children detected with any of 4D's during 2018-20 at one Urban Primary health center to assess their Quality of Life (QOL) and client satisfaction.

Materials and Methods

A total of 102 children <18 years were selected as per Probability Proportionate to Size for different 4D's; within each category required participants were selected randomly. Information was gathered on designed semi-structured proforma. For QOL, customized World Health organization Quality of Life Brief (WHO-BREF) Questionnaire tool was used. Client satisfaction about the RBSK was assessed among RBSK users (N = 46) with Likert scale.

Result

Out of 102 cases, 97 were covered including 8 with more than 1 type of 4Ds. Majority beneficiaries were male (53.1%), from 5 to 10 years age (43.8%), and middle social class (52%). Congenital defects (48.5%) especially heart defects were the most common followed by deficiency disorders (40.2%) mostly severe anemia and/or severe acute malnutrition. Out of 46 who availed RBSK services, 82.6% rated service as very good or good. Most children (81.7%) had good QOL.

Conclusion

Most detected 4D's belonged to school going age and middle class. They rated program as very good or good. Congenital defects, specifically heart defects were the most common. Overall, most children (81.7%) had good QOL.

Client satisfaction among HIV positive and HIV negative attendees in a military hospital in Southwest Nigeria

Background

In the management of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and other diseases, client satisfaction is of utmost importance as it improves hospital visits, and thus, allows sustainable decline in the prevalence rates. The aim of this study was to compare client satisfaction among HIV-positive and HIV-negative clients in a military secondary health center.

Methods

This was a comparative cross-sectional study conducted in a military hospital, among 200 HIV-positive and 200 HIV-negative patients, using structured interviewer-administered questionnaires. The data analysis was done with the SPSS version 20 software. The comparison of satisfaction with the quality of healthcare between HIV-positive and HIV-negative subjects was assessed using Chi-square tests.

Results

A higher proportion of HIV-positive respondents (40.5%) than HIV-negative respondents (13.0%) answered in the affirmative that healthcare workers were unwilling to care for them (P = < 0.001). Ninety-seven percent of the HIV-positive respondents and 71.5% of the HIV-negative respondents felt satisfied with how warmly they were received at the clinics (P = <0.001). Ninety-three percent of the HIV-positive respondents and 79.8% of the HIV-negative respondents were satisfied with the client confidentiality (P = <0.001). Regarding the overall client satisfaction, 68.0% of the HIV-positive respondents were satisfied while 45.5% of the HIV-negative respondents were satisfied (P < 0.001).

Conclusion

Overall, the HIV-positive clients were more satisfied than the HIV-negative clients. Efforts should be made to ensure that client satisfaction does not decline among the HIV population but should be optimized.

Client satisfaction with antenatal care among clinic attendees in a tertiary health institution in Calabar, Cross River State, Nigeria

Antenatal care is an important entry point to the health system and provides access to essential obstetric care. Satisfaction with different aspects of antenatal care, has the potential to improve health. This study aimed to determine the prevalence of satisfaction with Antenatal care services and identify factors influencing client satisfaction among antenatal clinic attendees in University of Calabar Teaching Hospital Calabar (UCTH), Cross River State. A descriptive cross-sectional study was conducted among 200 pregnant women attending the ANC in UCTH. Systematic random sampling technique was used to recruit participants and the Client Satisfaction questionnaire (CSQ8) measured satisfaction. Data was analysed using bivariate (Chi-square test) and multivariate (binary logistic regression) analysis. The overall level of satisfaction recorded in this study was 92%. Reasons for dissatisfaction were long waiting time 57%, cost of services 40.3%, clinic environment 31%, doctors assigned to ANC attendees 19% and attitude of doctors 13%. Being satisfied with their previous experience in the health facility was the only significant predictor of satisfaction in this study(p<0.05). Although a high level of satisfaction with ANC services was noted among pregnant women in UCTH, it is pertinent that waiting time, cost of services, toilet facilities and infrastructure be addressed.

Are clients satisfied with communication with health workers? A study among pregnant women attending primary health care centers in Nasarawa State, Nigeria

An effective communication between health workers and clients is known to improve clients' perception, compliance, and treatment outcomes. The main objective of this study was to determine the level of client satisfaction with health workers'-client communication among pregnant women attending ANC in selected PHC facilities Nasarawa State. The study was a cross-sectional design conducted among 450 respondents consenting pregnant women during their ANC sessions. Data was collected using a structured, interviewer-administered structured questionnaire. Analysis was done using SPSS software version 20. Chi-square test and logistic regression were used for the test of significance. Results showed that 132 (29.3%) of the respondents were completely satisfied with client health worker communication. The elements of communication with the highest satisfaction were: explanation of condition to clients: 193 (42.9%); use of appropriate language: 189 (42.0%) and courtesy and respect by the provider: 188 (41.0%). Conclusion. Clients with a secondary level of education and more were more likely to be satisfied with communication with health workers. There is a need to carry out regular reorientation of PHC workers on communication with clients.

Patient satisfaction with health care at a tertiary hospital in Northern Malawi: results from a triangulated cross-sectional study

Background

In 2016 the Malawi government embarked on several interrelated health sector reforms aimed at improving the quality of health services at all levels of care and attain Universal Health Coverage by 2030. Patient satisfaction with services is an important proxy measure of quality. We assessed patient satisfaction at a tertiary hospital in Northern Malawi to understand the current state.

Methods

We conducted exit interviews with patients aged ≥ 18 years using a 28 statement interviewer administered questionnaire. Patients were asked to express their level of agreement to each statement on a five-point Likert scale – strongly disagree to strongly agree, corresponding to scores of 1 to 5. Overall patient satisfaction was calculated by summing up the scores and dividing the sum by the number of statements. Mean score > 3 constituted satisfaction while mean score ≤ 3 constituted dissatisfaction. A χ² test was used to assess the association between overall patient satisfaction and demographic variables, visit type and clinic consulted at alpha 0.05. Patient self-rated satisfaction was determined from a single statement that asked patients to rate their satisfaction with services on a five-point Likert scale. We also asked patients to mention aspects of hospital care that they did not like. Responses were summarized into major issues which are presented according to frequencies.

Results

Overall patient satisfaction was 8.4% (95% CI: 5.2 − 12.9%). Self-rated patient satisfaction was 8.9% (95% CI: 5.5 − 13.4%). There was no significant association between overall patient satisfaction and all predictor variables assessed. Patients raised six major issues that dampened their health care seeking experience, including health workers reporting late to work, doctors not listening to patients concerns and neither examining them properly nor explaining the diagnosis, shortage of medicines, diagnostics and medical equipment, unprofessional conduct of health workers, poor sanitation and cleanliness, and health worker behaviour of favouring relatives and friends over other patients.

Conclusions

We found very low levels of patient satisfaction, suggesting that quality of services in the public health sector is still poor. It is, therefore, critical to accelerate and innovate the Ministry of Health’s quality improvement initiatives to attain Malawi’s health goals.

Green construction practices: ensuring client satisfaction through health and safety performance

Studies have proven that client satisfaction (CS) is greatly affected by the nature of construction practices on site. However, not much attention has been given to CS in projects that adopt green construction practices (GCPs). This study examines the effect of GCPs on CS, and the means by which CS can be achieved through health and safety performance (HSP). This study also analyses how the relationship between HSP and CS could vary depending on the level of GCPs adopted. A questionnaire with 27 items drawn from literature was used in collecting data from class A contractors in Nigeria. The study's hypotheses were tested using the partial least squares structural equation modelling (PLS-SEM) technique. The findings of the study reveal that GCPs have a positive effect on CS. HSP proved to only partially mediate the relationship between GCPs and CS. The findings also show that the effect of HSP on CS is moderated by GCPs with the stronger effect from projects with low adoption of GCPs. The study's findings highlight the pivotal role of HSP in ensuring CS in construction projects that adopt GCPs. This study makes practical contributions to the body of existing knowledge by highlighting the need for concerted efforts by contractors such as investing in health and safety training and ensuring site workers wear personal protective equipment aimed at adhering to acceptable health and safety standards. This can be achieved through provision of funds for safety activities, monitoring, and supervision of workers to guarantee HSP which translates to CS while adopting GCPs. However, the obstacles to these are the lack of safety culture by construction organizations, lack of enlightenment on the part of construction site workers, and poor safety climate on the construction project site. Additionally, the study provides greater insight on the practice of green construction among contractors by showing that the effect of HSP on CS would differ considerably on account of the level of GCPs adopted.

Psychosocial functioning among current noninjecting opioid users: Is there any difference between methadone maintenance treatment and treatment as usual?

BACKGROUND

Patients with opioid use disorder (OUD) have a significant problem in psychosocial functioning domains, which are not systematically studied in India. This study aimed to evaluate the psychosocial functioning in current noninjecting opioid users on Methadone Maintenance Treatment (MMT) versus Treatment as Usual (TaU: Chlordiazepoxide, Zolpidem, Trazodone, Tramadol, Tapentadol, and Buprenorphine).

MATERIALS AND METHODS

It is a cross-sectional study on patients of current noninjecting OUD on MMT or TaU for at least in the past month. Comorbidities and illness severity were assessed with the help of Mini-International Neuropsychiatric Interview 7.0.2 and World Health Organization-The Alcohol, Smoking, and Substance Involvement Screening Test 3.0, respectively. Social and occupational functioning assessment scale (SOFAS), WHO Quality of Life (WHOQoL-BREF), and Client Satisfaction Questionnaire (CSQ-8) assessed the sociooccupational functioning and QoL and client satisfaction. A total of 67 participants (37 on MMT and 30 on TaU) were included in the study.

RESULTS

A significant difference between the two groups (MMT better than TaU) was based on SOFAS scores, CSQ-8, and WHOQoL-BREF. In the TaU group, there was a significant negative correlation between risk of addiction severity with sociooccupational functioning (r = -0.5; P = 0.0046), physical health (r = -0.48; P = 0.0087) and social relationship (r = -0.47; P = 0.0087) domain of QoL. In the MMT group, the association between risk of addiction severity with sociooccupational functioning, domains of QoL, and client satisfaction were insignificant.

CONCLUSION

Sociooccupational Functioning, Client Satisfaction, and QoL of patients maintained on MMT are better than those on TaU.

Client satisfaction on community based health insurance scheme and associated factors at Boru Meda Hospital, Northeast, Ethiopia: institutional based cross-sectional study

Background

Community-based health insurance systems are usually voluntary and characterized by community members pooling funds and protecting themselves against the high costs of seeking medical care and treatment for illness. Client satisfaction with health service provision during the implementation of health insurance schemes has often been neglected. This study aimed to determine client satisfaction with the community-based health insurance scheme and associated factors.

Methods

An institutional-based cross-sectional study design was applied from February 22–March 11 /2019. A total of 420 study participants were included in the study using a systematic random sampling technique. Data were collected using a pretested semi-structured interviewer-administered questionnaire with a patient exit interview. Bivariate and multivariate logistic regression analyses were used to identify factors associated with Community-based Health Insurance of client satisfaction. Statistical significance was decided at a p-value less than 0.05.

Result

A total of 420 community-based health insurance clients of health service users participated in the study with a 100% response rate. The overall client satisfaction was 80% at 95% Cl (76.1, 83.9), respondents who have perceived that partially or none availability of prescribing drugs were 0.09 times less likely satisfied as compared to full availability of prescribing drugs (AOR =0.09; 95% Cl: (0.04, 0.19)). Besides, study participants waiting time to consult service providers within 30 min were more satisfied than those who were delayed 60 min and above (AOR =3.16; 95% Cl: (1.19, 8.41)).

Conclusion

Community-based health insurance client satisfaction provided in the present study was 80% indicating low proportion. Full availability of prescribing drugs, clients renewed their community-based health insurance membership, and preference of clients to use the hospital for future health care need were positively associated with client satisfaction while the perception of waiting time before physician consultation negatively affected client’s satisfaction. Therefore, the hospital management members and service providers need to give attention to reduce waiting time preceding consultation, improve drug availability, and sustain the hospital preference by the client.

Clients' perceptions of the quality of post-abortion care in eight health facilities in Dakar, Senegal

Post-abortion care (PAC) integrates elements that are vital for women's survival after abortion complications and their ability to meet their subsequent fertility intentions. Currently, the utilization of PAC among women in need remains too low, particularly in settings where unsafe abortion is an appreciable cause of maternal mortality. Interventions have aimed at addressing unmet need; however, these still require information on the extent to which women value different aspects of PAC. This paper presents such evidence from Dakar, Senegal. Exit interviews with 729 PAC clients in 2018 at eight health facilities obtained information on patient characteristics, content of services received and women's perceptions of the quality of care, both overall and according to subject-specific domains. These domains reflect aspects of PAC that are relevant to clients' satisfaction: accessibility, facility environment, information and counselling, family planning, provider technical competence and readiness and client-staff interaction. Ordinal logistic regression models were estimated to identify factors that were associated with women's rating of overall quality of care (on a scale of 1 to 5, 1 being lowest). Predictors that were significantly associated with the outcome were used in a multivariate ordinal logistic regression model that estimated the probability of positive differences in the outcome associated with women's classification of each predictor. Women reported a mean rating of 3.7 for overall quality of care. The lowest domain-specific rating was for quality of information and counselling (mean=2.4) and the highest was for client-staff interaction (mean=3.8). Factors associated with clients' higher odds of being more satisfied with PAC were: physical comfort during the procedure, recall of counselling on treatment procedure, privacy, perceived availability of supplies and medicines, facility admission process, facility cleanliness, waiting time, clarity of counselling and access to different contraceptive methods. Interventions that target these factors may improve the utilization of PAC in Dakar, Senegal.

Levels and dimensions of client satisfaction with the treatment of recent maternal, newborn and child health related illnesses by frontline health workers in rural Nigeria

Little is documented about levels of client satisfaction with maternal, newborn and child health services at primary health care (PHC) facilities in Nigeria, besides unsubstantiated anecdotes. This study examined different aspects of client satisfaction at primary healthcare level in Nigeria. Quantitative data were collected using personal digital assistants to capture responses from 1548 households in Bauchi and Cross River States. Descriptive statistics were used to summarize study results as frequency tables and percentages. Majority of the study respondents utilized government health facilities for treatment, however some clients used private sector health facilities. Women, newborns and under-fives were treated for a variety of illnesses and disease conditions. Treatment outcomes and levels of satisfaction did not appear to differ by cadre of healthcare provider. Respondents' level of satisfaction with healthcare services at primary healthcare level in Nigeria appear to reflect their modest quality of care expectations, especially in poor PHC rural settings.

Client Satisfaction with Community Health Workers in HIV Care Teams

Community health workers (CHWs) integrated in human immunodeficiency virus (HIV) care teams undertake a variety of tasks to help patients navigate health care, develop care plans, and address social needs. Given the broad role of CHWs in HIV care, we sought to understand which client attributes are associated with various dimensions of CHW satisfaction using a sample of 204 people with HIV (PWH) from various geographic regions across the United States. Multivariable linear regressions were used to determine which client attributes were associated with complete satisfaction with CHWs using 10 validated measures. The mean age of participants was 40.6 years old (SD = 12.8) and over 70% were Black or African American. Adjusted models reveal clients who were female, have marginal health literacy, or have a substance use disorder diagnosis were more likely to not be completely satisfied across multiple dimensions (p ≤ .05). Conversely, being housed and having a mental health diagnosis were associated with being more likely to be completely satisfied (p ≤ .04). Clients' sociodemographic characteristics and health conditions may be indicative of unique needs, leading to differing expectations of CHWs. CHW training modalities should consider the complex interplay of care needs based upon different client backgrounds and experiences among PWH. Addressing unique needs resulting from social determinants of health and that arise from conditions co-occurring with HIV, such as substance use disorders, should be incorporated into CHW service delivery.

Effects of automated teller machine service on client satisfaction in Commercial Bank of Ethiopia

This study was examined effects of automated teller machine (ATM) service quality on client satisfaction within the Commercial Bank of Ethiopia (CBE). During this study, the convenience sampling technique was employed. The study used primary and secondary data sources. Both quantitative and qualitative data types were collected. Data were analyzed by using five-point Likert scale and Econometric methods. Multinomial and ordered logit model was used to analyze the effect of service quality of ATM service on client satisfaction. The mean Likert scale result indicated that the respondents' attitude towards tangibles, reliability, responsiveness, assurance and empathy fall on 2.77, 2.98, 2.58, 3.02 & 3.23, respectively. The econometric result confirmed positive relationship between tangibles, reliability, responsiveness, empathy and assurance, and client satisfaction. Based on the finding of this study providing reliable network, educating customers on ATM usage, improving the security of ATM usage, increasing the number of ATMs, and increasing the amount of money withdrawn was recommended.

Linking supportive leadership to satisfaction with care: proposing and testing a service-profit chain inspired model in the context of elderly care

PURPOSE

As marketization has gained ground in elderly care, satisfaction with care has come to play a crucial role in designing for high-quality care. Inspired by the service-profit chain (SPC) model, the authors aimed to gain a deeper understanding of the intricate interplay between supportive leadership practices, organizational climate, job satisfaction and service quality by predicting satisfaction with care.

DESIGN/METHODOLOGY/APPROACH

A Swedish sample of frontline elderly care staff (n = 1,342) participated in a cross-sectional questionnaire study. Mediation analyses were conducted to test the proposed model.

FINDINGS

As predicted, engaging in supportive leadership practices was directly and positively associated with satisfaction with care. In addition, as predicted, this relationship was partially mediated by organizational climate and job satisfaction. Moreover, job satisfaction predicted satisfaction with care with service quality explaining a statistically significant part of this relationship.

PRACTICAL IMPLICATIONS

Managers in elderly care services may improve satisfaction with care in multiple ways but primarily by showing that they care about the staff and ensuring that they are satisfied with their working conditions. Employee job satisfaction seems to be particularly crucial for satisfaction with care, beyond what can be accounted for by care service quality.

ORIGINALITY/VALUE

The authors proposed a novel service-outcome model. Adding to the original SPC model, the model in this study suggested and validated previously unexplored relationships including a direct path between leadership practices and satisfaction with service and a multiple-mediator model explaining this relationship. Also, new measures of organizational climate and supportive leadership were developed for which satisfactory reliability estimates were obtained.

Patient Satisfaction with Telehealth in Rural Settings: A Systematic Review

Telehealth provides health care services to clients through telecommunications. Rehabilitation services such as occupational therapy, physical therapy, and speech-language therapy can be delivered via telehealth. The aim of this study was to evaluate patients' reports of their satisfaction with telehealth compared to standard in-person therapy for patients living in rural areas. Four databases were utilized for this systematic review. The following words were searched: telehealth, rural, and patient satisfaction. Abstract searches identified 251 articles, and 55 were read in full text. Four articles met inclusion criteria. There was high satisfaction for patients in all studies regarding the use of telehealth. Findings showed that overall, telehealth supported increased rates of patient satisfaction for OT, PT, and SLP services delivered to rural communities.

Clients' satisfaction with preventive services for malaria during pregnancy in Anambra state, Nigeria

BACKGROUND

Burden of Malaria in pregnancy (MIP) is still high despite availability of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance, but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients' satisfaction with preventative services for malaria during pregnancy delivered at antenatal clinics (ANC) in Anambra State Nigeria.

METHOD

We conducted a cross-sectional study among 284 pregnant women attending ANC using multistage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables.

RESULTS

The mean age of participants is 28 years±4.4 years. Overall, 62.2% were satisfied with quality of preventive services for malaria during pregnancy. However, 64.8 and 57.8% were dissatisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the respondents (88.73%) had poor knowledge of malaria preventive services during pregnancy. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18-0.90) were independently associated with satisfaction with interpersonal relationship. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39-6.74) were also independently associated with satisfaction with cost of healthcare.

CONCLUSION

A fair proportion of respondents were satisfied with the preventive services for malaria during pregnancy provided even though most were dissatisfied with the cost of assessing care and interpersonal relationship with health workers. Uninterrupted availability of long lasting insecticide treated bed nets and intermittent preventive treatment for malaria at all health facilities, subsidized cost of malaria-related commodities, and incentives for good customer satisfaction ratings may remediate the described barriers to seeking preventative care for malaria during pregnancy.

Data on post bank customer reviews from web

This document describes a set of customer feedback data concerning the Post Bank. We collected data from 16,659 feedback lines using the Beautiful Soup package from the authoritative site banki.ru is selected as the source of data for collection. The dataset is compiled to monitor the level of trust of bank customers in its banking service. The data presents text reviews for 2013 - 2019 and includes, with or without ratings. Scientists can predict feedback ratings with an empty value in the future. We added additional columns to the dataset with official comments of bank employees, as well as values for the fog-index by Gunning parameter, which is used for the readability of the text. The data can be useful for customer service managers to identify problems in customer service and solve these problems, to assess the dynamics of the appearance of positive and negative reviews of bank customers.

Predictors of Client Satisfaction Among Recent Users of Health Services in Lagos, Nigeria

Client satisfaction is an important measure of quality of care as it provides information on how well health service providers meet clients' values and expectations. The study was cross-sectional and analytical in nature. Data were obtained with the use of an interviewer-administered questionnaire. Respondents (n = 994) were a subset of a larger group of community members recruited for a study on quality of health care who had used a health facility for care within 3 months prior to data collection. A total of 94% of clients were satisfied with services received although client satisfaction rates were higher with private than public health facilities. Waiting time of less than 20 minutes (adjusted odds ratio [AOR] = 9.35, 95% confidence interval [CI] = 2.08-41.67), cheap cost of all services received (AOR = 7.58, 95% CI = 1.95-29.41), and the ability of the health care provider to offer explanations clearly to clients (AOR = 6.21, 95% CI = 1.90-20.41) were predictors of client satisfaction. However, the use of a government-owned hospital (AOR = 0.23, 95% CI = 0.08-0.63) was predictive of client dissatisfaction. Only service characteristics were predictive of client satisfaction. Improvement in service delivery is recommended.

Level of adult client satisfaction with clinic flow time and services of an integrated non-communicable disease-HIV testing services clinic in Soweto, South Africa: a cross-sectional study

BACKGROUND

While HIV Testing Services (HTS) have increased, many South Africans have not been tested. Non-communicable diseases (NCDs) are the top cause of death worldwide. Integrated NCD-HTS could be a strategy to control both epidemics. Healthcare service strategies depends partially on positive user experience. We investigated client satisfaction of services and clinic flow time of an integrated NCD-HTS clinic.

METHODS

This prospective, cross-sectional study evaluated HTS client satisfaction with an HTS clinic at two phases. Phase 1 (February-June 2018) utilised standard HTS services: counsellor-led height/weight/blood pressure measurements, HIV rapid testing, and symptoms screening for sexually transmitted infections/Tuberculosis. Phase 2 (June 2018-March 2019) further integrated counsellor-led obesity screening (body mass index/abdominal circumference measurements), rapid cholesterol/glucose testing; and nurse-led Chlamydia and human papilloma virus (HPV)/cervical cancer screening. Socio-demographics, proportion of repeat clients, clinic flow time, and client survey data (open/closed-ended questions using five-point Likert scale) are reported. Fisher's exact test, chi-square analysis, and Kruskal Wallis test conducted comparisons. Multiple linear regression determined predictors associated with clinic time. Content thematic analysis was conducted for free response data.

RESULTS

Two hundred eighty-four and three hundred thirty-three participants were from Phase 1 and 2, respectively (N = 617). Phase 1 participants were significantly older (median age 36.5 (28.0-43.0) years vs. 31.0 (25.0-40.0) years; p = 0.0003), divorced/widowed (6.7%, [n = 19/282] vs. 2.4%, [n = 8/332]; p = 0.0091); had tertiary education (27.9%, [n = 79/283] vs. 20.1%, [n = 67/333]; p = 0.0234); and less female (53.9%, [n = 153/284] vs 67.6%, [n = 225/333]; p = 0.0005), compared to Phase 2. Phase 2 had 10.2% repeat clients (n = 34/333), and 97.9% (n = 320/327) were 'very satisfied' with integrated NCD-HTS, despite standard HTS having significantly shorter median time for counsellor-led HTS (36.5, interquartile range [IQR]: 31.0-45.0 vs. 41.5, IQR: 35.0-51.0; p < 0.0001). Phase 2 associations with longer clinic time were clients living together/married (est = 6.548; p = 0.0467), more tests conducted (est = 3.922; p < 0.0001), higher overall satisfaction score (est = 1.210; p = 0.0201). Those who matriculated experienced less clinic time (est = - 7.250; p = 0.0253).

CONCLUSIONS

It is possible to integrate counsellor-led NCD rapid testing into standard HTS within historical HTS timeframes, yielding client satisfaction. Rapid cholesterol/glucose testing should be integrated into standard HTS. Research is required on the impact of cervical cancer/HPV screenings to HTS clinic flow to determine if it could be scaled up within the public sector.

Client satisfaction on Emergency department services and quality of emergency medical care in Ethiopia: A systematic review

BACKGROUND

The utilization of the emergency department to provide an emergency medical services is crucial for the communities who need an urgent medical care that is associated with various cases. This aim of this review was to describe the client satisfaction on the services of Emergency department and the quality of emergency medical care in Ethiopia.

METHOD

We searched peer-reviewed published articles related to clients' satisfaction on emergency department services and the quality of emergency medical care between January 2000 and December 2017. The articles were retrieved from databases of PubMed, Scopus, Ovid, Google Scholar, MEDLINE, EMBASE and ScienceDirect. Furthermore, studies published in other language than English was excluded.

RESULTS

A total of 2094 participants: 906 (43%) males and 1188 (57%) females were recruited in those reviewed papers to express their satisfaction on the service and the quality of emergency medical care of the Emergency department. Based on the study findings, majority 1177 (56%) of the participants were satisfied by emergency outpatient department (OPD) services. The majority 1018 (83%) of the participants were satisfied with the manner that was showed by the staffs working at the Emergency OPD. In similar manner, the satisfaction level of the participants in the Emergency OPD towards the accessibility of the emergency care services, courtesy of the staffs, quality of the services, physical environments, and existence of good communication with services provider were 72%, 97%, 81.5%, 55%, and 66%, respectively while 97.2% of them were dissatisfied with their privacy. On the other hand, 76% of the participants were satisfied with the service provided in the radiology section and other laboratory work.

CONCLUSION

This study finding shown that there was the variety of client perception on the emergency department and its quality care. Therefore, Emergency outpatient department should be raised progressively further by health care managers, governmental executives, EMS directorate, and others to address the efficient attribute of deprived value of health care and continuity of care delivery system being tied with new policy in Ethiopia.

Whose System is it Anyway? How Clients and Providers Evaluate the Impact of Session EHR Use on Communication in Mental Health Treatment

Electronic health records are common in mental health settings. While providers often express concern that in-session computing will damage client-provider communication, some work suggests that clients do not share this worry. As the majority of this research has been conducted in medical settings, less is known about how clients evaluate in session computing in mental health treatment, and whether this pattern of discordance persists in this setting. This study describes and compares the perceived impact of in-session computing on communication in mental health treatment from the clients and provider perspective, and examined sources of variation in client ratings. Thirteen providers and 53 clients participated in this study, representing 53 unique client-provider dyads. Results suggest that providers perceived in-session computing as more harmful to communication than clients. Client ratings varied by race, age and visit type but were not influenced by how often the computer was used during session.

Determinants of client satisfaction with family planning services in public health facilities of Jigjiga town, Eastern Ethiopia

BACKGROUND

Client satisfaction is the best indicator of quality service provision and has been found to correlate with continuity of care perceived by the client. The measurement of client satisfaction helps in understanding willingness and decisions to return for future services. Thus, this study aimed at assessing the level and factors associated with client satisfaction of FP services among family planning users.

METHODS

An institutional based cross-sectional study was conducted on 492 family planning users in Public health facilities of Jigjiga town, Eastern Ethiopia from February 10 to March 10, 2017. Participants were chosen by systematic random sampling and interviewed immediately after having received family planning service using via a structured and pre-tested questionnaire. The data were entered into Epi Info 7 and then exported to SPSS 20 for analysis. All associations with client satisfaction were tested for statistical significance with alpha set at the 0.05 level.

RESULT

The findings of this study showed that the overall client satisfaction with FP services among FP users of public health facilities of Jigjiga town was 41.7% with 95% CI of (37 - 46.1%). Knowledge on FP [adjusted odds ratio, AOR (95% CI) = 0.037 (0.019-0.072)], demonstrate how to use the method [AOR (95% CI) = 16.1 (8.4-30.7)], describing side effect of the method [AOR (95% CI) = 2.4 (1.41-4.23)] and distance of FP user's home to health facility [AOR (95% CI) = 0.24 (0.14-0.42)] were found to be significantly associated with the client satisfaction of FP services.

CONCLUSIONS

The overall client satisfaction with FP services was relatively low. Knowledge of FP, demonstrating how to use the method, describing the side effect of the method and distance of FP user's home to health facilities were found to be factors that influence client satisfaction with family planning services. Thus, efforts should be made to improve on client interaction especially on the information given and knowledge of clients.

Women's overall satisfaction with health facility delivery services in Ghana: a mixed-methods study

Background

Skilled birth delivery has increased up to nearly 74% in Ghana, but its quality has been questioned over the years. As understanding women's satisfaction could be important to improving service quality, this study aimed to determine what factors were associated with women's overall satisfaction with delivery services quantitatively and qualitatively in rural Ghanaian health facilities.

Results

This cross-sectional, mixed methods study used an explanatory sequential design across three Ghana Health Service research areas in 2013. Participants were women who had delivered in the preceding 2 years. Two-stage random sampling was used to recruit women for the quantitative survey. Relationships between women's socio-demographic characteristics and their overall satisfaction with health facility delivery services were examined using univariate and multiple logistic regression analyses. For qualitative analyses, women who completed the quantitative survey were purposively selected to participate in focus group discussions. Data from the focus group discussions were analyzed based on predefined and emerging themes. Overall, 1130 women were included in the quantitative analyses and 136 women participated in 15 focus group discussions. Women's mean age was 29 years. Nearly all women (94%) were satisfied with the overall services received during delivery. Women with middle level/junior high school education [adjusted odds ratio (AOR) = 0.50, 95% confidence interval (CI) = (0.26-0.98)] were less likely to be satisfied with overall delivery services compared to women with no education. Qualitatively, women were not satisfied with the unconventional demands, negative attitude, and unavailability of healthcare workers, as well as the long wait time.

Conclusions

Although most women were satisfied with the overall service they received during delivery, they were not satisfied with specific aspects of the health services; therefore, higher quality service delivery is necessary to improve women's satisfaction. Additional sensitivity training and a reduction in work hours may also improve the experience of clients.

Assessment of women's satisfaction with family planning service at public health facilities in Northwest Region of Ethiopia: a cross sectional study

BACKGROUND

Ethiopia is a Sub Saharan African country with an estimated contraceptive prevalence rate of 36% and 22% unmet need for family planning service among married women. Client satisfaction influences the use of Family Planning and other reproductive health services. There is limited information on satisfaction with family planning service among Family planning users particularly in the northern part of Ethiopia. Hence, this study aimed to provide information on client satisfaction and its determinant among women in Public Health facilities of Northwestern Ethiopia.

METHODS

A Facility based cross-sectional study was conducted from March 1, 2017, to March 30, 2017. An exit interview using structured pretested questionnaire was conducted on randomly selected 490 women attending family planning service in Bahir Dar city, Public Health facilities of Northwest, Ethiopia. The data was cleaned, coded and entered into Epi info™ 7 statistical software and then exported and analyzed using SPSS Version 20 statistical software. A multivariable binary logistic regression model was fitted to identify factors associated with Client satisfaction. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association.

RESULTS

A total of 490 family planning service users were approached for an interview and making a response rate of 99.8%. The overall client satisfaction with the family planning services was found to be 66.1%. Clients who were merchants were more likely to be satisfied with the family planning service than government employees [AOR = 2.5, P-value = 0.007). In addition, house wife's more likely to be satisfied with the family planning service than government employees AOR = 2.4, P-value = 0.007). Daily laborers were also found to be more likely to be satisfied with the FP service as compared with governmental employees AOR = 3.9, P-value = 0.007). New Family Planning user clients were more likely to be satisfied with the family planning service than repeat users [AOR = 2.3, P-value = 0.004).Family planning service waiting time also affects client satisfaction, in which those having awaiting time of less than half an hour's (AOR = 9.7, (P-value =001), One to half an hour (AOR = 6.4, (P-value =001), One hour to two hours (AOR = 4.6, (P-value =001) were more likely to be satisfied with the family planning service delivered at the facility than those who had waited for more than two hours. In addition, those whose privacy was maintained during counseling were more likely to be satisfied with the family planning service delivered than whose privacy was not maintained (AOR = 3.2, P-Value = < 0.001). Those having convenient service hour were more likely to be satisfied with the family planning service delivered than those who don't have convenient service hour (AOR = 2.4, p-value = 0.002).

CONCLUSION

The finding of this study concludes that nearly two -third of the clients were satisfied with the family planning service delivered at Public Health facilities of Northwest of Ethiopia. New family planning service users, waiting time for the service, Maintaining privacy during counseling, having convenient service hour and occupational status of the clients were the predictors for client satisfaction with family planning service delivered at Public Health facilities in Bahir Dar city.

Survey dataset on factors that influence satisfaction of clients with architectural services in Lagos State, Nigeria

The retention of clients of professional service practitioners is often dependent on their satisfaction with the services they obtain. This article presents data on the factors that influence the satisfaction of clients with architectural services in Lagos State, Nigeria. Data were obtained from a cross-sectional survey research, which adopted random sampling of clients from six estates in the State. The questionnaire was used as an instrument for the survey. The response rate was 81.3%. The dataset is made available in tables and charts of frequencies and means. The data are of interest to researchers in the professional service organisation, management and those in the decision sciences. The data could also be of interest to practitioners who may further analyse the data to develop business strategies to satisfy their clients.

Client satisfaction with family planning services in the area of high unmet need: evidence from Tanzania Service Provision Assessment Survey, 2014-2015

BACKGROUND

Client satisfaction has been found to be an important factor for the uptake and continuation of family planning services. This study aimed to examine the current status of and factors associated with client's satisfaction with family planning services in Tanzania, which has a high unmet need for family planning.

METHODS

The study used data from the Tanzania Service Provision Assessment survey of 2014-2015. A facility was classified as having high service readiness for FP if it scored at least 67.7% on a composite score based on three domains (staff training and guidelines, basic diagnostic equipment, and basic medicines), following criteria developed by the World Health Organization. The exit interview questionnaire was used to collect information from women about their level of satisfaction, whether "very satisfied," "more or less satisfied," or not satisfied with the services received. The response was dichotomized into "Yes" if the woman reported being very satisfied with services received otherwise coded as "No". Unadjusted and adjusted logistic regression models were used to assess the association between the client satisfaction and covariate variables; service readiness, facility type, managing authority, location, management meetings, supervision, provider's sex, and working experience, clients' age and education. All analyses were weighted to correct for non-response, disproportionate and complex sampling by using the "SVY" command in Stata 14.

RESULTS

Out of the 1188 facilities included in the survey, 427 (35.9%) provided family planning services. A total of 1746 women participated in observations and exit interviews. Few (22%) facilities had a high readiness to provide family planning services. While most facilities had the recommended equipment available, only 42% stocked contraceptives (e.g. oral pills, injectable contraceptives and/or condoms). Further, trained staff and clinical guidelines were present in only 30% of services. Nevertheless, the majority (91%) of clients reported that they were satisfied with services. In the multivariate analysis, a high service readiness score [AOR = 2.5, 95% CI; 1.1-6.0], receiving services from private facilities [AOR = 2.3, 95% CI; 1.1-5.0], and being in the age group 20 to 29 years [AOR = 0.3, 95% CI; 0.1-0.7] were all significantly associated with clients' satisfaction with family planning services.

CONCLUSION

There is a high level of client satisfaction with family planning services in Tanzania. Maintaining and exceeding this level will require improvements in the provision of staff training and the availability of contraceptives in existing services.

Measuring the success of canine and feline preventative healthcare consultations: A systematic review

Preventative healthcare consultations account for a large proportion of the veterinary caseload. This novel study is the first to methodically review all literature on canine and feline preventative healthcare consultations. Previous research has found these consultations to be different from health problem consultations in terms of communication style and content. Identifying relevant evidence and previously validated methods of measuring the success of these consultations will be useful when implementing strategies for optimisation. The aim of this study was to identify and assess the quality of existing literature which describes and/or measures the success of preventative healthcare consultations. Database searches of CAB Abstracts and Medline were conducted to identify published literature. Google searches were then conducted to identify any additional published or grey literature. Results were systematically screened to determine whether the returned sources were about cats and/or dogs, whether they related to preventative healthcare, and whether they described and/or measured the success of preventative healthcare consultations. For primary research citations which only described preventative healthcare consultations, data were extracted on the aspects of the consultations described. For citations which additionally measured the success of the consultations, the measures used, sampling technique, key results and key weaknesses were also extracted. Of 17,538 citations identified in total during the database searches, a total of seven relevant primary research citations were identified. All of these citations described aspects of the preventative healthcare consultation, such as consultation length, health problems discussed, actions taken and communication style. Only one primary research citation measured success of the consultation, using veterinarian satisfaction to determine success. In addition, 30 narrative citations, including expert opinion pieces, textbooks, guidelines without transparent methodology and conference presentations were identified. Google searches identified 224 relevant narrative citations, and five of the seven primary research citations identified by the database searches, but did not identify any additional relevant primary research citations. The results suggest that, despite accounting for around a third of all consultations, there is relatively little evidence describing preventative healthcare consultations and only one measure of success has been described for these consultations. This presents potential challenges when implementing strategies to optimise these consultations, as measures which are useful and relevant to veterinary practice should first be identified. Identifying useful measures of success will allow future strategies designed to maximise the benefits of these consultations to be meaningfully assessed for efficacy.

Predictors of Client Satisfaction with Outpatient Mental Health Clinic Services in Italy and New York

The aim of this cross-sectional study was to assess factors associated with client satisfaction in two mental health outpatient settings in Italy and the US. Sociodemographic and clinical variables, hope, and personality characteristics were evaluated in 18-65-year-old patients who had been receiving services for at least 2 months in one of two outpatient clinics, in Italy and the US. Patients were administered: the Healthy Days Core Module, the Kessler Screening Scale for Psychological Distress, the Verona Service Satisfaction Survey, the Client Satisfaction Inventory, the Health Service OutPatient Experience questionnaire, the Herth Hope Index, and the NEO Five-Factor Inventory-3. Bivariate tests for differences between the two samples were conducted, a Satisfaction Composite z-score was computed, and a stepwise, backward elimination, multiple linear regression model-including the variables that were significantly associated with Satisfaction Composite Score in bivariate tests-was built. From July 1, 2015 to April 30, 2016, 184 patients (121 in Foligno, 63 in New York City) were enrolled in the study. Predictors of client satisfaction included: receiving services in New York City, being older, having lower educational attainment, having inner positive readiness and expectancy as well as interconnectedness with self and others, and high scores on the agreeableness personality domain. Interestingly, diagnosis and treatment characteristics did not influence satisfaction. Client satisfaction with outpatient mental health services is mainly influenced by sociodemographic characteristics and personality factors more than clinical variables or patterns of care. These findings could have implications regarding trends toward value-based payment models.

A systematic scoping review of parental satisfaction with child protection services

Obtaining parent views on child protection services is an essential part of evaluating service quality and effectiveness. It also promotes the principles of listening to parents and involving them in decision-making. The present review analysed published research that investigated parental perspectives on the child protection services they received. It identified 52 studies published between 2000 and 2016 on parent satisfaction. Most used qualitative methods, and eight standardised survey instruments were used in quantitative studies. Factors related to parent satisfaction or dissatisfaction related to the attitudes and skills of workers, the interventions provided, and aspects of the child protection system. The body of research provides guidance for policymakers and practitioners about strategies to measure and improve client satisfaction.

Factors determining satisfaction among facility-based maternity clients in Nepal

Background

With an increasing number of institutional deliveries, the Nepalese health system faces a challenge to ensure a quality of service provision. This paper aims to identify the determinants of client satisfaction with maternity care in Nepal using data from a nationally representative health facility survey.

Methods

A total of 447 exit interviews, with women who had either recently delivered or who had experienced obstetric complications, were conducted across 13 districts in Nepal (87% in hospitals, 8% in Primary Health Care Centres (PHCCs), and 5% in Sub/Health Posts(S/HPs). Client satisfaction was measured using an eight item scale that covered accessibility, interpersonal communication, physical environment, technical aspect of care and decision making. A client satisfaction index was computed using ordinal principal component analysis. A multivariate probit model was used to assess the net effect of explanatory variables on client satisfaction.

Results

Longer waiting times and overcrowding increased the likelihood of dissatisfaction. Having an opportunity to ask questions was positively associated with client satisfaction. Respondents from hill districts and rural areas were more likely to be satisfied in comparison to respondents from mountain, terai and urban areas. Socio-demographic factors (age, parity, caste/ethnicity, education, and ecological zone) and supply side factors (the time taken to reach a facility, type of facility, payment for services, and unknown heath worker or anyone entering the delivery room) were not statistically associated with satisfaction.

Conclusions

The findings suggest client satisfaction with the quality of maternity services in Nepal could be improved by reducing waiting times and overcrowding, and giving the mothers adequate time to ask questions. If clients are more satisfied they are more likely to use the facility again/recommend to a friend.

Medical abortion can be provided safely and effectively by pharmacy workers trained within a harm reduction framework: Nepal

OBJECTIVES

To examine the treatment efficacy, safety and satisfaction of women using medical abortion (MA) pills provided by pharmacists following an education intervention based on a harm reduction approach.

STUDY DESIGN

This was an operations research study over a six-month period in 2015, using a non-inferiority design. We provided training to dispense MA pills, based on a harm reduction approach, to a group of pharmacy workers in Makwanpur district (GROUP 2). We compared selected outcomes with women who bought the pills from pharmacy workers in Chitwan district (GROUP 1), who had received similar training in 2010. The primary endpoint measured in 992 women in both districts was complete abortion within 30 days of using the pills. We assessed the efficacy of MA (self-reported complete abortion) and safety (no reported adverse event). To determine complete abortion, we asked women about passage of the products of conception, cessation of abdominal cramps, vaginal bleeding, need for manual vacuum aspiration or repeated doses of misoprostol. We used a four-point Lickert Scale to determine level of satisfaction with MA use. Pearson Chi-Square test was used to examine any differences in proportion of complete abortions between women who were served by the two groups of pharmacy workers.

RESULTS

The difference in the rate of complete abortions between the two groups of women, 96.9% and 98.8%, was not statistically significant. The women reported no serious complications, and there was little difference in their satisfaction levels.

CONCLUSIONS

Trained pharmacy workers dispensed MA safely and effectively to the satisfaction of almost all women clients, and the positive results of training had continued several years later.

IMPLICATIONS

The role of pharmacy workers as providers of correct and complete information on safe and effective use of MA needs to be recognized and policies formulated to allow them to provide MA drugs for first trimester use.

An evaluation of Interprofessional group antenatal care: a prospective comparative study

Background

Maternal and neonatal outcomes are influenced by the nature of antenatal care. Standard pregnancy care is provided on an individual basis, with one-on-one appointments between a client and family doctor, midwife or obstetrician. A novel, group-based antenatal care delivery model was developed in the United States in the 1990s and is growing in popularity beyond the borders of the USA. The purpose of this study was to evaluate outcomes in clients receiving interprofessional group perinatal care versus interprofessional individual care in a Canadian setting.

Methods

Clients attending the South Community Birth Program (SCBP), an interprofessional, collaborative, primary care maternity program, offering both individual and group care, were invited to participate in the study. Pregnancy knowledge and satisfaction scores, and perinatal outcomes were compared between those receiving group versus individual care. Chi-square tests, general linear models and logistic regression were used to compare the questionnaire scores and perinatal outcomes between cohorts.

Results

Three hundred three clients participated in the study. Group care was comparable to individual care in terms of mode of birth, gestational age at birth, infant birth weight, breastfeeding rates, pregnancy knowledge, preparedness for labour and baby care, and client satisfaction. The rates of adverse perinatal outcomes were extremely low amongst SCBP clients, regardless of the type of care received (preterm birth rates ~5%). Breastfeeding rates were very high amongst all study participants (> 78% exclusive breastfeeding), as were measures of pregnancy knowledge and satisfaction.

Conclusions

This is the first Canadian study to compare outcomes in clients receiving interprofessional group care versus individual care. Our observation that interprofessional group care outcomes and satisfaction were as good as interprofessional individual care has important implications for the antenatal care of clients and for addressing the projected maternity provider crisis facing Canada, particularly in small and rural communities. Further study of group-based care including not only client satisfaction, but also provider satisfaction, is needed. In addition, research into the role of interprofessional care in meeting the needs and improving perinatal outcomes of different populations is necessary.

Client satisfaction in a faith-based health network: findings from a survey in Uganda

Background

Client satisfaction surveys are important in evaluating quality of the healthcare processes and contribute to health service improvements by assisting health program managers to develop appropriate strategies. The goal of this study was to assess clients' level of satisfaction with services provided by private-not-for-profit member health facilities affiliated to Uganda Protestant Medical Bureau.

Methods

This was a cross-sectional descriptive study using an interviewer-administered questionnaire conducted in 254/278 (91%) of UPMB member health facilities between 27th April and 14th July 2014 among 927 clients. The tool measured ten dimensions of the care-seeking experience namely; health facility access; waiting time; health providers; support staff; rights; payments; facilities and environment; consent; confidentiality; and the overall care seeking experience. Logistic regression was utilised for multivariate analysis.

Results

Overall client satisfaction was found to be high within the UPMB network (84.2%). Most of the client satisfaction dimensions were rated above 70% except payments and rights. There was evidence of association with marital status; single/never married were 3.05 times more likely to be dissatisfied compared to widowed. Clients attending HCIII were less likely to be dissatisfied compared to those attending HCII (OR=0.51, 95% CI: 0.25–1.05). Post-secondary education (OR=1.79; 95% CI 1.01–3.17), being formally employed (OR=2.78, 95% CI: 0.91–8.48) or unemployed (OR=3.34, 95% CI: 1.00–11.17), attendance at a hospital (OR=2.15, 95% CI: 1.36– 3.41) were also associated with high dissatisfaction levels with payments.

Conclusion

This study found a high level of satisfaction with services in the UPMB network but recorded low client satisfaction with the dimensions of rights and payments. Health workers should take time to explain rights and entitlement as well as charges levied to clients.

Quality of care in family planning services in Senegal and their outcomes

BACKGROUND

High quality of care in family planning (FP) services has been found to be associated with increased and continued use of contraceptive methods. The interpersonal skills and technical competence of the provider is one of the main components of quality of care. To study the process component of quality of care, the distribution of the FP counseling topics was examined by client, provider and facility characteristics. To assess the outcomes of quality of care, client satisfaction and their knowledge of their method's protection from STIs were used. This study examined the factors associated with these outcomes with a focus on provider counseling and training.

METHODS

Data from the 2012-2013 Senegal Service Provision Assessment survey was used for the analysis. The survey included a representative sample of the health facilities in Senegal and collects data by observing the clients' FP visits and conducting exit interviews. The main outcomes of interest were provider's counseling in FP, client's satisfaction with FP services and client's knowledge of their method's protection from STIs. Several covariates were used in the analysis which represent client, provider and facility characteristics.

RESULTS

The level of counseling was inadequate-- very low proportions of providers that performed different types of counseling. Counseling was more likely to be provided to new than returning clients. Approximately 84% of the clients were very satisfied with services but only 58% had correct knowledge of their method's protection from STIs. Clients were significantly less likely to be very satisfied when their providers counseled on side effects and when to return, and counseling provided on method's protection from STIs did not significantly improve knowledge in this area. Clients seen by a provider with FP training had almost twice the odds of having correct knowledge about their method's protection from STIs compared with clients seen by a provider with no recent training.

CONCLUSIONS

The percentage of providers offering FP counseling to their clients was relatively low and was ineffective on the client-focused outcomes. Interventions may be required for more effective counseling methods that are client-centered as well as providing more FP training to providers.

Client satisfaction and transfers across care levels of women with uncomplicated pregnancies at the onset of labor

OBJECTIVE

to compare the client satisfaction of women with uncomplicated pregnancies at the onset of labor who were transferred across care levels during childbirth and women who were not transferred across care levels in the Dutch perinatal healthcare system, and-if there are differences-to identify the variables that may explain them.

METHODS

the research entailed a population-based study of women with uncomplicated pregnancies at the onset of labor living in the catchment area of a Dutch Neonatal Intensive Care Unit (NICU) in the eastern part of the Netherlands who gave birth between April 2014 and September 2014. Respondents completed a validated questionnaire (n = 842; mean age 30.7 years). Client satisfaction, measured on a 10-point scale, was assessed within 12 weeks after childbirth.

FINDINGS

of the 842 respondents, 277 women experienced a transfer of care during childbirth, and 565 women were not transferred. The client satisfaction of women who were transferred across care levels (mean 8.04; SD 1.4) was significantly lower (p<0.001) than that of women who were not transferred across care levels (mean 8.78; SD 0.9). Seven variables together explained 93.2% of the difference in client satisfaction. Explanatory pregnancy and childbirth variables were perceived health problems for the mother and medical interventions during childbirth. Explanatory clients' experiences with the care process variables were respect, prompt attention, quality of basic amenities, social consideration, and choice and continuity.

CONCLUSION

women were highly satisfied with the care they received, although transfers across care levels during childbirth were associated with substantially lower client satisfaction. The differences in client satisfaction between transferred and non-transferred women can largely be explained by pregnancy and childbirth characteristics, and by clients' experiences with the care process.

Are Users Satisfied with Assertive Community Treatment in Spite of Personal Restrictions?

The purpose of this explorative study was to examine satisfaction among 70 users of 12 Norwegian Assertive Community Treatment teams. The study was carried out among a group of 70 service users, and reveals generally high levels of satisfaction with the service, with satisfaction also being high in comparison to other ACT satisfaction studies. Users under a Community Treatment Order were more satisfied, while users with an alcohol use disorder were less satisfied. Younger service users were less positive than older users. There was no difference in satisfaction between the genders. This study's positive result may reflect the ACT model's focus on user involvement, recovery and building relationships, and the fact that this service has a more holistic approach than previous services that users have experienced.

Client satisfaction determinants in four Kenyan slums

PURPOSE

In Kenya, gaps exist in health service provision to slum residents, especially service availability and access to quality care. There is also little information on the health status of people living in slums other than in Nairobi. The purpose of this paper is to generate evidence for use in designing interventions to improve health services in four mid-sized slums in Embu, Nyeri and Thika, Kenya.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional survey of clients receiving services in health facilities was conducted in the targeted slums. Data were collected through face-to-face interviews. Factor scores were generated using the Rasch model; simple and multivariate logistic regression analyses were done using the R statistical software.

FINDINGS

Overall, 81 per cent of the 203 participants reported being satisfied with health services. Most clients (89 per cent) reported that health facility staff greeted them warmly; 82 per cent said their consultation was private. The facility type, waiting time and client experience with service providers determined their satisfaction (p<0.05).

PRACTICAL IMPLICATIONS

Healthcare managers can improve client satisfaction levels by understanding the client flow in their facilities and addressing causes of client dissatisfaction, such as long waiting times, while at the same time promoting facilitating factors.

ORIGINALITY/VALUE

The authors use latent variable modelling to compute client satisfaction scores, which were dichotomised into two categories and fitted into a logistic regression model to identify factors that influence client satisfaction. Health facility clients in the four slums are satisfied with services and have confidence the providers will serve them in a friendly and professional manner that promotes respect and quality care. The paper recommend healthcare managers in similar settings carry out client flow analysis and institute remedial measures to address long waiting times. Qualitative studies are recommended to determine the reasons behind the high satisfaction levels reported in this study.

Client Satisfaction with Quality of Health Care in a Rural area in Southern India

BACKGROUND

Client satisfaction is an important method to assess the pattern of utilization of health care services amongst all sectors indirectly reflecting on the quality of services. Most of the clients prefer private over government services due to multiple reasons.

AIM

To assess the level of satisfaction of patients attending rural government and private health facilities in rural Andhra Pradesh.

METHODS

Ten villages were randomly selected from the field practice area of a teaching medical institution, and all patients who visited any facility during the past three months were interviewed using a semi-structured questionnaire focusing on access to care, competence of the providers, quality and cost of the services and overall satisfaction with the services. Data was analysed using Microsoft Access software.

RESULTS

One hundred and eight clients who visited different facilities for common ailments, chronic diseases, maternal and child health services were interviewed. The average time to reach the facility was 52.23 ± 44.52 minutes. The average waiting time was 34.25 ± 42.47 minutes. More than 80% were satisfied with the clinic hours, cleanliness and comfort of the facility, and privacy maintained during examinations. 40% were satisfied with the cost of services.

CONCLUSION

The client satisfaction with different health care providers in rural areas of Andhra Pradesh is high. Clients expect the quality of services to be better; nevertheless they continue to use the available services without complaining much.

based on the client satisfaction approach: view of the students

STUDY OBJECTIVES

Based on several data sets collected from 2009/10 to 2011/12 school years, this study examined the views of 242,705 students participating in the Tier 1 Program in the extension phase of the Project P.A.T.H.S. in Hong Kong.

DESIGN

Students responded to a validated client satisfaction measure after completion of the program. Analyses were based on the reports submitted by the schools participating in the project.

RESULTS

High proportions of the students viewed the program, implementers, and benefits of the program in a favorable light. Compared with students in lower grades, students in higher grades showed relatively lower satisfaction ratings, although the differences were small. Perceived qualities of program and instructor predicted perceived effectiveness of the program.

CONCLUSION

The Tier 1 Program was received favorably by the students. Perceived qualities of the program and the program implementers predicted perceived program effectiveness. The findings are consistent with those reported in the initial phase of the project.

Assessment of client satisfaction in labor and delivery services at a maternity referral hospital in Ethiopia

Introduction

Patients perception about service quality shapes their confidence with regard to use of the available health care facility. This study is aimed to assess the client`s satisfaction in a maternal health care setting.

Methods

This is an institution based cross sectional descriptive study. A total of 423 postpartum women were interviewed. Data was analyzed using SPSS version 20 statistical package.

Results

The proportion of mothers who are completely satisfied with health care ranges between 2.4 to 21%. Pain control was the poorest source of satisfaction with 82% reporting dissatisfaction. Provider's communication with clients yielded complete satisfaction rates ranging between 0.7 to 26%. Inadequate information about the drug prescribed and explanation of procedures to be done to the client were found to be major causes of dissatisfaction. The complete satisfaction rate with environmental factor of the hospital was between 3.3 to 40.2%. Age of the client, educational status, income of the client and client's address away from Addis Ababa were found to be the predictors of client satisfaction. Provider's attitude and communication, as well as longer duration of stay in the ward were independent predictors of client satisfaction.

Conclusion

Pain management, client privacy and client provider communication need to be addressed to ensure the satisfaction of maternity clients. The clients need to be involved in the management of their own health problems.

High Satisfaction Rating by Users of Private-for-profit Healthcare Providers-evidence from a Cross-sectional Survey Among Inpatients of a Private Tertiary Level Hospital of North India

Background:

Evaluation of outcomes can help improve the quality of provision of services within a healthcare setting. There is limited report on patient satisfaction in private-sector in India although they provide three-quarters of healthcare services.

Aim:

The study was designed to report the level of satisfaction among inpatients of a private tertiary care hospital in India.

Materials and Methods:

A total of 102 participants were recruited and their socio-demographic, health-seeking behavior, and satisfaction rating on various aspects of healthcare were elicited. A five item Likert scale was used to obtain the satisfaction rating. Data analysis was done with the help of Stata version-9. Proportions for the discrete variables and means with Standard Deviation for the continuous variables were obtained.

Results:

All the participants were urban and from upper-middle or upper socio-economic strata. The participants reported a high level of overall satisfaction (93%) as well as high satisfaction with physicians (95%), the doctor's interpersonal skills (99%), nursing-care (93%), general services (94%), and pharmacy (88.1%).

Conclusion:

There was a high level of satisfaction reported by the participants at this tertiary level hospital. This might reflect the actual good quality services being provided by the provider or the nonannoying response, which cannot be ruled out.

Community Perception and Client Satisfaction about the Primary Health Care Services in an Urban Resettlement Colony of New Delhi

Research Question:

This study attempts to assess the community perception and client satisfaction of primary health care services provided by mobile health clinics.

Objectives:

To assess the awareness of the community about mobile health clinic services and its utilization in an urban area and to assess the client satisfaction of those who have utilized the services.

Study Design:

A cross-sectional community-based study.

Setting:

Dr. Ambedkar Nagar, urban resettlement colony of New Delhi.

Study Period:

July 2006 and September 2006.

Participants:

For exit interviews, patients who have utilized the mobile health clinic; for community interviews, an adult member present in the family.

Materials and Methods:

For the community survey, two blocks were randomly chosen and the interview was carried out by house visits. For exit interviews, patients were selected randomly from those attending the mobile health clinic.

Statistical Analysis:

Descriptive statistical analysis.

Results and Conclusions:

A total of 377 interviews were conducted (295 community interviews and 82 exit interviews). It was seen that 82% were aware of the mobile health clinic but more than two-thirds preferred private practitioners; reasons given were that they have more trust in private practitioners, convenient timings, and less waiting time. Approximately two-thirds to three-fourths of the clients were satisfied with the mobile health clinic services. Client satisfaction is an important measure of the quality of health care and needs to be addressed in order to improve the utilization of primary health care services in urban areas.