Client Perception of Quality of Health Care in Bawku West District of the Upper East Region of the Republic of Ghana

Abstract

As calls are made by health professional groups and clients for a more client-centered health care system, it becomes essential to define and measure patient perceptions of health care quality and to understand more fully what drives those perceptions. The aim of this study is to describe client perceived quality of health care and satisfaction with care in selected public health facilities in Bawku West District. The study was a cross-sectional survey conducted in three health facilities in Bawku West District to describe the quality of health care from the clients‘ perspective. It was undertaken over a period of three months, from June to August 2009. Exit interviews were carried out for 265 clients aged15 years and above who reported to the general OPD, antenatal clinic and post natal clinics. The caretakers of clients who were less than 15 years were also interviewed. Both quantitative and qualitative methods of data collection were employed. Descriptive analysis and logistic regression were done using Epi Info 6 Version 3.4.1. The results indicate that perception of quality of care and client satisfaction were high in all the three facilities. Mean score for quality of care was highest for the health centre (3.24) followed by the clinic (3.20) and then the hospital (3.15). Mean satisfaction score also follows the same trend with the health centre recording 3.16, the clinic 3.15 and the hospital 3.08. Quality of care in the hospital was positively associated with adequacy medicines prescribed (p < 0.05) and the most significant predictors of client satisfaction are examining the client (p < 0.05), adequacy of medicines prescribed (p < 0.005), cleanliness of the facility (p < 0.05), privacy during consultation (p < 0.05) and quality of care (p < 0.0001). Most significant predictor of client satisfaction in the health centre is respect for clients (p < 0.05). It is concluded that perception of quality of care and satisfaction are very high in all the facilities. Nonetheless there are gaps in communication with the client, provider/client relationship and availability of medicines that need to be addressed. It is recommended that the facilities improve on communication with clients, provider/client relationship and availability of medicines.