Quality of routine immunization service: Perception of clients.

Abstract

Immunization prevents over 2-3 million deaths each year worldwide. In India, even though vaccines are offered free of cost at public health facilities the coverage remains low. Limited scrutiny has been conducted at health service and client interface for routine immunization (RI) services, which may have been affecting the acceptance of vaccines. This emphasizes the importance of assessing the level of satisfaction and perceived quality of clients regarding RI services. This study aimed to assess the perceived quality and level of overall general satisfaction with RI services of clients. In addition, determine the association of factors influencing clients perceived quality and overall general satisfaction with RI services. A community-based cross-sectional study was conducted in an urbanized village of Delhi from November 2015 to April 2017. A total of 279 RI visits were covered in the study, and the clients were interviewed at their residence using a pretested tool. The dissatisfaction toward the domains of perceived quality of RI services was reported to be 3.2% for vaccine availability, 9.7% for vaccine information, 3.2% for staff behavior, 6.1% for doctor behavior, and 7.5% for infrastructure. Multivariable-regression analysis indicated that distance to health facility, literacy and age of the client, doctor behavior, staff behavior, and infrastructure had an effect on overall general satisfaction of client toward RI services. The client's perception is multidimensional; improvement in one domain is likely to strengthen the other. By understanding the client's perspective toward quality of RI service, the health-care mangers may improve the level of overall satisfaction.