Service Users’ Perspectives on Healthcare Quality in Rural Northern Ghana: A Cross-Sectional Mixed Methods Study
Abile, Moses, Anarwat, Samuel George, Yarney, Lily.
Background: Despite improvements in healthcare access and utilization among various populations around the globe, factors responsible for individual decisions to seek healthcare services vary with different populations and geographical context. The study aimed to examine service users’ perspectives on the satisfaction with quality of healthcare delivery services they receive at healthcare facilities and its effect on their decision to access and utilize healthcare services.
Methods: Using a cross-sectional survey and two separate focus group discussions (comprising 6 persons in each group), as well as an in-depth interview of three healthcare managers, data were collected from 401 respondents in selected communities in the Bole District of the Northern Region of Ghana using a questionnaire. The survey data were analyzed using Pearson correlation and logistic regression in SPSS version 21 while qualitative data were analyzed and synthesized using content analysis.
Results: The results of the study revealed that 31% of the respondents were dissatisfied with the healthcare services’ delivery. Using a Pearson Correlation analysis, respondents’ satisfaction with healthcare services delivery was significantly associated with an individuals’ health insurance status (Ῥ = 0.00), distance to health facility (Ῥ = 0.01), treatment procedures (Ῥ = 0.00), and personal factors such as educational level (Ῥ = 0.00). The logistic regression model, χ2 = 7.003, P<.0005, explained 25.2% (Nagelkerke R2) of the variance in users’ satisfaction with healthcare service delivery and correctly classified 79.1% of cases. Staff attitude was associated with 2.5 times likelihood of users being satisfied while increased distance was negatively associated with having satisfactory healthcare service delivery. Qualitative data collected pointed to poor staff attitude toward patients, poor diagnostic measures, and unavailability of medications as factors affecting their satisfaction with the quality of healthcare provided in the district.
Conclusions: A third of the study population (31%) in the district were not satisfied with the healthcare services delivery. Proper supervision and refresher training for health staff on quality healthcare delivery, and adequate provision of essential drugs and consumables could improve the patients’ satisfaction with healthcare services delivery and utilization.
