Assessment of the quality of Primary Health Care in Rivers State
Majority of patients in Nigeria makes use of primary health care facilities but little is known of their perception on the quality of care they receive from these facilities. The quality of patient's experiences of healthcare services, which is expressed in their satisfaction with the care they receive, has become an important perspective in the evaluation of healthcare quality. This study aim's to assess the quality of primary health care in Rivers State from the patients' perspective.
Across-sectional survey with participants recruited through a multi stage sampling approach was utilized. Primary health centers in Rumuigbo, Oyigbo and Abonnema representing the three senatorial subdivisions in Rivers State, Nigeria were the study sites. A previously validated multi- scale instrument - Outpatient Assessment of Health care questionnaire with five domains and a 4- point Likert scale response -1 (strongly disagree) to 4 (strongly agree) and a global satisfaction scale on 0 -10 response options, was used to assess patient satisfaction and healthcare quality. The main outcome measures were Patients' satisfaction with doctors and nurses' communication, health care environment, health and medication communication.
423 adult patients visiting these centres for care on outpatient basis who gave their consent participated in this study. The mean age of the respondents was 29.6 ± 5.9 years and majority were female (92.1%), self-employed (47.0%) and married (90.1%). Overall, majority (67.5%) of the respondents were satisfied with the care they receive at these health centers. Mean satisfaction scores were highest (91.5%) for their communication with their doctor and this was followed by nurses' communication (88.7%), hospital environment (70.3%) and health communication (62.73%). The dissatisfaction of the respondents over medication communication was expressed in the observed low mean satisfaction rating of 15.5%. Predictors of high satisfaction were increasing age (p = 0.005) and those that perceived their current health status as being excellent (p < 0.001).
Patients appear to be generally pleased with the care they received at the health centres. We recommend an improvement in the practice of educating patients on the drugs that are prescribed and dispensed to them.
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