Clients' perception of the quality of primary health service and its predictors in Rivers State

Abstract

Introduction: Most patients in Rivers State seek health care from primary health centres which recently had undergone modernization. However not enough is known of their perception on the quality of service delivery. This study assessed perceived quality of primary health care and identified predictors in the context of Rivers State.

Method: Cross-sectional survey using multi stage sampling approach. A multi scale instrument - Outpatient Assessment of Health care questionnaire was used to obtain feedback from 423 adult patients visiting three randomly selected primary health centres, representing the three senatorial districts in Rivers State. Outcome measured were patients' satisfaction with doctors and nurses' communication, health care environment, health and medication communication as well as their global rating of the centres. Predictors of perceived quality of PHC were explored using regression analyses with p-value < 0.005 considered significant.

Results: Mean age of the respondents was 29.6 ± 5.9 years with majority being female (92.1%), self-employed (47.0%) and married (90.1%). Majority (67.5%) of the respondents were satisfied with the care they received at the health centres, with mean satisfaction scores of 3.41, 3.45, 3.16 and 3.48 out of a possible maximum of 4 for doctors, nurses, environment and consultation domain respectively. Less proportion of the respondents (59.9%) were satisfied with the quality of information about prescribed medications. Predictors of high rating in this study were older age (standardised β = 0.22, 95% CI: 0.14 – 0.29, P<0.001), consultation with doctors (p = 0.001), free health care (p<0.001), higher self rated health status (p < 0.001) and being a first time visitor to the health Centre (p<0.001).

Conclusions: Although patients are generally pleased with services at health centres but there is need to improve the clarity of information given on prescribed medications. Some negative predictors which are within the remit of the health system should form the focus for quality improvement.

Keywords: Quality assessment, Patients' Perception, Predictors, Primary health care, Rivers state, Nigeria