Evaluating patient`s satisfaction and quality perception towards health services rendered at JTH, a major referral Hospital mostly depending on external Donners, Juba / South Sudan

Abstract

Patient satisfaction is the perception of patient towards health care services, has been considered a mandatory barometer to evaluate how well a healthcare system is working in a number of advanced countries such as France and Germany, however, it receives limited attention in developing countries,1 Improved patient care has become a priority for all health care service providers with the optimum objective of achieving a high degree of patient satisfaction, therefore is the state of pleasure or happiness that the patients experience while using a health services.2 According to Emmanuel K Mpinga3 has moved from theoretical essence to more technical and operational approach, corresponds to expression of patient’s judgment on the quality of care, is an indicator and the voice of the patient, on other hand6 found that socio - demographic characteristics contribute minimally to patient satisfaction, patient who is anxious will not comprehend information clearly. In South Sudan generally, is perceived that there is a gap in needs of patients despite external donor`s efforts, hence patients seek healthcare in private health centers. Improving the quality of health care service offered at JTH will improve the service offered Nationwide directly or indirectly. This study is a cross-sectional studies, exploratory based on qualitative interviews one - to one investigator and patient, while structured questionnaire are given to Doctors and Nurses, the Study population aged 15 to 55yrs old, males and females, regardless of occupation and educational levels from all departments, Simple random samples were attained from the period between1st Oct 2012- 14th Jan2013 from various wards to reached 50 patients, 20 doctors and 30 nurses were given structured questionnaires which they filled. Followed by extensive discussions and analysis was done using MS Excel &MS Word, data presentation is in the form of plain text, tables, graphs and pie charts. Results & conclusions: The general performance of doctors and nurses is positive, despite the minority are dissatisfied, 22% of patients residing outside Capital Juba while 78% in Juba City. In regards to education level only 12% had tertiary education, while secondary level with 36% the remaining 52% had none or minimal education, the age group 15-24 had the highest unemployment rate while age 45-54 the least, 78% of the participants agreed that there was no language barrier, only 22% who had communication difficulty, South Sudan is a multi-ethnic country in which some patients speak their mother tongues or dialects only, 72% of the patients felt that privacy was observed while 28% contrary, because consultation rooms usually overcrowded with medical students, patients are examined in front of students and co-patients, Patients tend to hide information when they feel their privacy is at stake, leads to patients’ dissatisfaction. follow up of patients scored high when doctors’ performance was evaluated, However, some slight deviation could be due to doctors working in shifts, swift clinical examinations, impoliteness to colleagues, most doctors are interns and so their competency is always being questioned. JTH is under equipped and it has few Specialists, and the management of chronic cases almost futile attempt. Majority of health care providers at JTH have good attitude towards patients. few answered negatively. The breaches were in the areas of drugs administration, 70% of doctors felt that nurses don’t administer drugs with right doses and timely as prescribed, only 30% believe contrary, 90% of nurses feel they over worked, hindering the quality of care services, in JTH nurses working in strenuous shifts and high patient to nurse ratio with no allowance’s payments, and luck of in service training or luck of capacity building. Inadequate facilities hamper health services in our exploratory studies and investigations, all agreed that improvement of facilities need urgency with 35% agreed for Lab,78.2% agreed for OPD, while 54.2% wards need improvement, 51.6% for pharmacy. high patients to doctor’s ratio resulting in patients taking long to see doctors and their investigation results done. Patients share beds in the emergency wards; others sleep on the floor and outside the ward receiving the treatment this deteriorates patient`s dissatisfaction towards the capacity of the hospital to deliver services. Paradoxically, many patients still prefer JTH as a final resort, Therefore, JTH should rise the capacity of OPD, increase the healthcare workers and increase incentives and motivation, create good working environment. Medical students should be trained basic medical emergency on triage in order to handle growing number of patients. The laboratory should be modernized, and the management of Hospital should be given to who holds administrative and managerial skills.