Assessing the quality of health care delivery in Ejisu-Juaben Municipality: Clients’ perception and an audit of care

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JUNE, 2015
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Background: Client satisfaction is an important indicator of the quality of health care and ascertaining their views remain essential to assessing the quality of health care provided. The objective of this study was to determine clients' perceptions of the quality of health care delivery, and to conduct an audit of selected health facilities in Ejisu – Juaben Municipality. Methodology: This was an analytical cross sectional study conducted in six purposively-selected private and public health facilities in the Ejisu Juaben Municipality, over a period of three months using structured pre-tested questionnaire and a check list. Categorical variables were compared using the chi-squared test and continuous variables compared using percentages frequencies. Factors associated with clients’ choice of orthodox health facilities as the first point of call were examined using regression analysis with robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant Result: Overall, 400 clients seeking care were recruited from the selected health facilities together with 12 unit and facility heads. Majority (80%) of respondents in both public and private facilities were satisfied with the quality of healthcare they received, and perceived the quality of care in the municipality to be generally good. Clients who were younger than 20 years old (adjusted RR 1.14; 95% CI, 1.10-1.52), Christians (adjusted RR 1.19; 95% CI 1.04-1.36) and those who had registered with the National Health Insurance Scheme (adjusted RR 1.12; 95% CI 1.02-1.36) were more likely to visit orthodox health facilities as the first point of call. Using service quality attributes, most respondents (range 71- 83%) assessed the quality of care to be good. The audit revealed that most of the facilities had the basic infrastructure and equipment, and provided the required basic clinical care and services. Although the public health facilities had relatively more trained health care providers, monitoring and supervision were better in the private health facilities. Conclusion: Generally, the quality of health care delivery was perceived to be high. Private health care facilities should be encouraged to recruit more trained health care providers while monitoring and supervision in the public facilities are improved upon.
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A thesis submitted to the Department of Health Policy, Management and Economics, School of Public Health, College of Health Sciences in partial fulfillment as a requirement for the degree of Master’s in Public Health, Health Services Planning and Management , 2015.
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