Shimeles Ololo

Determinants of patient satisfaction with outpatient health services at public and private hospitals in Addis Ababa, Ethiopia

Abstract Background Patients have explicit desires or requests for services when they visit hospitals. However, inadequate discovery of their needs may result in patient dissatisfaction. This study aimed to determine the levels and determinants of patient satisfaction with outpatient health services provided at public and private hospitals in Addis Ababa, Central Ethiopia. Methods A comparative cross-sectional study was conducted from 27 March to 30 April 2010. The study included 5 private and 5 public hospitals. Participants were selected using systematic random sampling. A pre-tested and contextually prepared structured questionnaire was used to conduct interviews. Descriptive statistics, analysis of variance, factor analysis and multiple linear regressions were performed using computer software (SPSS 16.0). Results About 18.0% of the patients at the public hospitals were very satisfied whilst 47.9% were just satisfied with the corresponding proportions a bit higher at private hospitals. Self-judged health status, expectation about the services, perceived adequacy of consultation duration, perceived providers’ technical competency, perceived welcoming approach and perceived body signalling were determinants of satisfaction at both public and private hospitals. Conclusions Although patients at the private hospitals were more satisfied than those at the public hospitals with the health care they received, five of the predictors of patient satisfaction in this study were common to both settings. Thus, hospitals in both categories should work to improve the competencies of their employees, particularly health professionals, to win the interests of the clients and have a physical structure that better fits the expectations of the patients.

Willingness to join community-based health insurance among rural households of Debub Bench District, Bench Maji Zone, Southwest Ethiopia

BackgroundEven though Ethiopia bears high burden of diseases, utilization of modern health care services is limited. One of the reasons for low utilization of healthcare services is the user-fee charges. Moving away from out-of-pocket charges for healthcare at the time of use is an important step towards averting the financial hardship associated with paying for health service. Prepaid plans for health are not accustomed in Ethiopia. Therefore, social and community based health insurance schemes were introduced since 2010.In this study, willingness of rural households in Debub Bench District, to join community based health insurance was assessed.MethodCross-sectional community based study was conducted in Debub Bench District in March 2013 using a pretested structured questionnaire. Two stage sampling technique was used to select 845 households as study units which were allocated to the kebeles proportionately. The sampled households were selected using simple random sampling technique. Data were entered into EPIDATA 3.0 and analyzed with SPSS version 20.ResultAmong 845 sampled households, 808 were interviewed (95.6% response rate). About 78% of the respondents were willing to join the scheme. Most of demographic, socioeconomic variables and social capital were found to be significantly associated with willingness to join community based health insurance.ConclusionIf the scheme is initiated in the district, majority of the households will enroll in the community based health insurance. Farmers, the married households, Bench ethnic groups and illiterate, the dominant segments of the population, are more likely to enroll the schemes. Therefore initiation of the scheme is beneficial in the district.

Quality of Antenatal Care Services in Demba Gofa Woreda, Gamo Gofa Zone, Rural Ethiopia

Background: Antenatal care is one of the evidence based interventions to decrease the probability of negative health outcomes for mothers and their newborns. This depends on the quality of care provided during each antenatal care visit. However little is known about factors contributing to quality of antenatal care service in public health center of Demba Gofa woreda. Objectives: To assess quality of antenatal care services in public health centers of Demba Gofa woreda. Methods: A facility-based cross sectional study design using quantitative and qualitative data conducted from March 25 to April 16‚ 2014. Using systematic random sampling method from 423 study subjects a sample of 418 pregnant women were sampled. The quantitative data was entered in to EpiData version 3.1 and was exported to SPSS version 20.0 for analysis. Bivariate and multiple variables analysis were carried out to identify factors associated with client satisfaction of antenatal care services. Variables with p value <0.05 were considered as statistically significant. Adjusted odds ratios were used to see the strength of association with 95% CI. Qualitative data was analyzed thematically by manually. The results were triangulated with quantitative data. Result: The proportion of mothers who were satisfied with antenatal care in this study was 21.5%. Women’s satisfaction with antenatal care was associated with frequency of ANC visit (AOR=1.9‚ 95% CI: (1.1, 3.3)), advise on nutrition (AOR=3.3‚ 95% CI: 1.3‚ 8.5), advise on birth preparedness (AOR=3.3‚ 95% CI: 1.1‚ 9.3)), closeness of the health center to mothers home (AOR=2.3‚ 95% CI 1.3‚ 3.9)). Provision of iron (AOR=0.14 (95% CI: 0.05‚ 0.3). Charge for service (AOR=3.4‚ (95% CI: 1.2‚ 9.5). Moreover 373 (89.2%) of the women received tetanus toxoid vaccine‚ 324 (77.5) mothers started antenatal care visit after first trimester. The recommended care component such as Venereal Disease Research Laboratory (VDRL) test, blood group and Rhesus factor tests were not done for most of the women. There was 67.18% over all skilled human resource gaps and none of the health professionals had taken training on focused antenatal care. Conclusion: The overall satisfaction of antenatal care services in this study was found to be low. First ANC visit‚ lack of advice on nutrition‚ lack of advice on birth preparedness‚ farness of the health center to mother’s home‚ provision of iron and Charge for service were independently associated with mothers satisfaction of antenatal care. As well lack of skilled health personal and not under taking recommended laboratory tests were revealed.