Assessment of Service Delivery System and Customer Satisfaction at Rural Health Centers: The case of Two Health Centers in Wuchale Woreda, Oromia Regional State of Ethiopia
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Date
2019-10
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A.A.U.
Abstract
Health service delivery system is not well organized at rural health centers as urban health facilities and hence curative and preventive health service provision is not adequate, accessible, and consistent as urban health facilities. At studied rural health centers the service units are inadequate in number and inappropriate for quality health service deliveries. Health resources allocation is insuffcient. Infrastructures, internal facilities and technology supported services especially computer supported services at each service unit is poor. Hence, this study was aimed to assess the service delivery systems and associated customer satisfaction at two rural health centers in Wuchale woreda. It is to assess the health service delivery system mechanisms, status and associated customer satisfaction at outpatient, maternal and child health services so that to identify the current practices and challenges in implementing health policies. The researcher insisted on deep study to identify the major factors affecting level of customer satisfaction regarding curative and preventive components of health service deliveries at rural settings. Mixed methods of research methodology was used to address the research questions. Primary data was collected through structured and semi-structured questionnaires. In addition to customer focused questionnaires, 11 key informant interviews and 5 focus group discussions were conducted for different categories of respondents which was in structured and unstructured forms in order to enhance the depth of the study. Secondary data from different offices and web-sites was also used for the study. The data collected from multiple sources was analyzed using both quantitative and qualitative analysis methods. As studied health centers standards were below the minimum service delivery standards of health centers, and this combined with shortage of resource allocations significantly affected quality health services; and to ensure accessibility, continuity and equity for clients found at different socio-economic status and locations. As a result service provisions remained at substandard in providing quality health services as customer expectations. The overall level of customers’ satisfaction at all departments of two health centers was recorded below 52%. Shortage of skilled human resources, medical, supplies especially drugs, contraceptives, vaccines, laboratory services, lack and inappropriate service units, facilities, inadequate technical abilities and competences are among factors that hinders quality health service provisions. Level of customer satisfaction is also largely linked with accountability and responsibility of supportive staff to help clients around card room and health workers to provide responsive, regular, consistent, quality and on time health services. Friendliness and respectful communication, compassions, consultations, immediate and feasible referral system viz. transportation, price of drugs, service providers willingness and helpfulness, able to offer receipt immediately for what clients paid for also has affected customer satisfaction from health services. Based on the findings, the researcher recommends rural primary health center decentralization to all kebeles with sufficient health resources allocation. This plays a significant role to ensure health service quality, accessibility and equity for people who located remotely from existing health centers with inappropriate road systems at rural settings. It is also needed rural health centers relentless effort for quality health service delivery system improvements and health center service provision capacity building activities with local government to ensure implementation of national health policy based on strategic programmes.It needs creating strong and nearest linkage between local health workers and communities.
Description
A Thesis Submitted to Addis Ababa University College of Business and Economics, Department of
Public Administration and Development Management in Partial Fulfillment of the Requirements for
the Degree of Masters in Public Management and Policy Specialized in Development Management
Keywords
Customer Satisfaction, Health service quality