Client Satisfaction Survey Research Articles

Examining a Child Welfare Parenting Intervention for Parents With Intellectual Disabilities

Purpose: There is scant child welfare research on parenting interventions for parents with intellectual and developmental disabilities (I/DD). This mixed-methods research examined client participation in an in-home parenting intervention, including client characteristics, which clients benefit most from participation, and key aspects of program participation. Method: The sample included participant program records, client satisfaction surveys, stakeholder interviews, and a staff focus group. The quantitative data were analyzed using growth curves and binary logistic regression. The qualitative data were analyzed using thematic analysis. Results: Time spent in Project Improving Parenting Achievements Together was predictive of improvement in parenting skills and the home environment and reduction in the odds of out-of-home placement for children of parents with I/DD. The intensity of services, tailored education, community engagement, and client–worker relationship were the key aspects of program participation. Discussion: With proper supports, parents with I/DD can learn parenting skills, improve the home environment, and keep their family intact.

How does audit firm emphasis on client relationship quality influence auditors’ inferences about and responses to potential persuasion in client communications?

Many audit firms use client relationship management tools (e.g., client satisfaction surveys); however, overemphasizing relationship quality potentially makes auditors susceptible to client influence. Audit seniors, the main point of contact with clients, could be most vulnerable. In an experiment, we manipulate the presence of a potential client persuasion attempt in response to auditor inquiry (expressions of high confidence) and an audit firm’s emphasis on relationship quality (desire to achieve high client satisfaction ratings for the current year’s audit). We examine how these variables jointly influence the extent to which audit seniors infer persuasion from client explanations and, importantly, whether that inference is reflected in their actions. We find that auditors infer to an incrementally greater extent that client persuasion is present when they encounter high confidence when relationship quality is emphasized; however, they do not respond by collecting more relevant audit evidence under these conditions. Our findings suggest that auditors do not pursue audit evidence that could reduce their reliance on client-provided information and, thereby, limit client influence, even when they infer client persuasion to a greater extent.

Psychosocial After-Care to Increase Quality of Life?

This study examines to what extent individuals who need psychosocial support actually benefit from the following support services: capability-oriented activities, mobile caring and support, psychosocial counselling centre, and assisted living. Furthermore, the impact of these support services on clients' quality of life is investigated. We statistically analysed data (n = 2,099) collected via client satisfaction surveys over five years (2013 to 2017). The clients reported the benefits they experienced regarding various aspects such as living, coping with everyday life, or confidence, as well as their perceived quality of life. The data suggest, that psychosocial after-care can improve and stabilize clients' quality of life. Clients of all types of support services reported similar improvements of their quality of life. However, clients from different types of support services reported different kinds of benefits, and, accordingly, improvements in quality of life were predicted from different kinds of benefits.

Patient Satisfaction with Use of Telemedicine in University Clinic of Psychiatry: Skopje, North Macedonia During COVID-19 Pandemic.

Background: There is increasing interest in the use of telemedicine as a means of health care delivery especially in circumstances of pandemics. This is partly because technological advances have made the equipment less expensive and simpler to use and partly because increasing health care costs and patient expectations have increased the need to find alternative modes of health care delivery. Introduction: Telemedicine and telepsychiatry, in particular, are rapidly becoming important delivery approaches to providing clinical care and information to patients in cases wherein the medical resources and the patients are very hard to be brought together with respect to rules of behavior in case of epidemics. The reliance on technology to bridge the obstacles between the patients (consumers) and medical resources (providers) can create problems that impact service delivery and outcomes, but in cases such as this (COVID-19 pandemics), this is virtually the only tool for providing clinical care and information to patients. Materials and Methods: A client satisfaction survey was undertaken in a daily hospital (a part of University Clinic of Psychiatry in Skopje). The anonymous modified self-report questionnaire (short form patient satisfaction questionnaire [PSQ-18]) covering demographic, gender, and age variables was endorsed by 28 participants. The mean age of the subjects was 40.25 ± 22 years, with a small majority of men (18 participants) versus women (11 participants). Results: Overall satisfaction with psychiatric care was high (80.22%). None of the demographic or other variables correlated significantly with satisfaction. Discussion: We had to reduce rate and time length of our face-to-face contacts with patients as a result of pandemics but they were able to reach their doctors virtually at all times. Conclusions: Many mental health professionals are using widely available, commercial software downloaded from the internet to provide care directly to a patient's home.

Checking in with Your Document Delivery User Base: Creating, Implementing, and Learning from Client Satisfaction Surveys

In 2017, Document Delivery Services (DDS) at Memorial Sloan Kettering Cancer Center Medical Library launched a customer satisfaction survey. The last time a survey of this nature was implemented was in 2009, before switching to ILLiad for the management of resource sharing requests. Due to the changing nature of content accessibility and online research methods, the DDS team felt that the time was right to survey their users again to seek feedback in support of service improvements. Questions were created to evaluate users’ satisfaction and knowledge of the service and related resources. New survey results were compared where possible to those received in 2009 to determine if survey results had changed over time. Enhancements were made to the service based on responses received in the 2017 survey.

A cross sectional study on factors influencing the quality of primary health care services provided by multi-purpose health workers in Tiruvallur district, Tamil Nadu

Background: Primary health care definition extends beyond physical aspect to mental and social wellbeing. Health care providers starting from physicians till basic level workers, play a vital role in identifying and meeting client’s health care needs. Quality care is the ability of to meet the health related needs of the population consistent with local and national goals, as well as resource constraints and considered as complex variable encompassing both tangibles and intangibles. Multipurpose workers are the frontline workers were the health problems were sorted out or referred to the next level of health care.Objective: The objective of the study is to identify enablers to a quality primary health care service in Tiruvallur district, state Tamil Nadu.Methodology: This is an analytical cross sectional study carried out on 149 Multi-purpose Health Workers calculated assuming maximum variability and 80% power. The study area Thiruvallur was selected through random sampling and five blocks namely Kadambathur, Minjur, Ellapuram, Tiruvalangadu and Tirutani were selected using lottery method. Parks The study was carried out during the period between January 2019 and June 2019. A structured questionnaire was used to elicit responses. Data were entered on MS Excel sheet. Statistical analysis was done with SPSS 17 version.Results and Discussion: Out of the total 149 Multi-purpose worker included in the study, 98 (65.77%) were females. Majority of them (34.90%) fall within the age group of 3 to 31-40 years. Among them 49.66% have completed their higher secondary level education. Around 57.04% have completed more than 15 years of service. Their structural indicators were below the expected standards compared to process and outcome indicators.Conclusion: Majority of the works were done properly except some defects in the structural level. Resources and Budgets should be reassessed and reallocated. Accredited activities should be made mandatory and should be considered as achievement by the entire health team. Regular audit and appraisal sessions are necessary. MPHW and client satisfaction survey should be done periodically to ensure the quality of services.

Local HIV/AIDS NGOs and Client Satisfaction: Dimensions and Explanatory Factors through a Multilevel Regression Analysis

Background: HIV/AIDS Non-governmental organizations (NGOs) in Benin can use evaluations (including client satisfaction surveys) as tools to improve the effectiveness of their interventions. Objective: It is to identify the dimensions of NGO clients’ satisfaction and their associated factors. Methods: We conducted a cross-sectional survey of 2413 clients receiving both preventive and curative services from 31 NGOs working in HIV/AIDS prevention-screening and providing care to persons living with HIV. Results: We identified four dimensions of satisfaction relevant to our setting: reception and humane attitude, accessibility of care and resources, staff availability and competence and continuity of care. Individual factors [(age positively and gender (men negatively)] statistically significantly influenced global satisfaction and three of its four dimensions but the strength of these associations was too weak. Concerning organizational factors, involvement in evaluation had a negative effect on reception and humane attitude. A local source as principal source of funding was associated with greater satisfaction with accessibility of care and resources, while foreign partners as the principal source of funding were associated with greater satisfaction in terms of both global satisfaction and its dimensions, except for continuity of care. Organizational factors explain from 12.5% to 15.6% of the variance of global satisfaction and its dimensions (except for continuity of care). Conclusion: These information on the global satisfaction and its dimensions as well as the influencing factors are important for NGOs and their partners as these can help them to plan and implement actions to improve performance.

Birth companion of choice: a survey amongst women who have given birth at a rural hospital in Limpopo, South Africa

Background: Advancements in medical interventions have contributed to the prevention of innumerable deaths of women and newborns globally, leading to the medicalization of childbirth, which may have inadvertently contributed to a dehumanization of the birthing experience by denying women the social and emotional support that they enjoyed when giving birth in the home environment. The WHO places equal importance on the quality of clinical care and the quality of experience of care. Emotional support, provided by a birth companion of choice, is critical for enhancing the experience of care during labour and birth. This study explores advocacy for women to have a birth companion, as well as perceptions of women about having a birth companion during labour and birth in a rural sub-district of Limpopo Province in South Africa. Methods: A cross-sectional study based on a continuous electronic RMC client satisfaction survey, on an on-line platform, which was completed by 506 women in a postnatal ward of a rural district hospital. Observations of interactions between midwives, women in labour and their birth companions during labour and birth were conducted in the same hospital. The survey data was analysed using descriptive statistics in Excel, and comprises both univariate and bi-variate analyses. The qualitative data from the observations was analysed using thematic analysis techniques. Results: Over 80% of women who completed the survey reported that they were informed about what a birth companion is and encouraged to register a birth companion at the health facility where they were attending antenatal care. Almost half of the women (49%) who were encouraged to bring a birth companion, had a birth companion during labour, whereas 15% of those not encouraged to bring a birth companion, had a birth companion during labour. The respondents who were feeling neutral, happy and very happy about having a birth companion were most likely to recommend having a birth companion to their family member or friends. Conclusion: The findings show that encouraging and supporting the presence of a woman’s companion of choice during labour and childbirth is an effective intervention that is respectful of women’s autonomy and agency and which is crucial for improving quality of clinical care and the experience of care during labour and birth

Improving the Birth Registration Service Using Kotter's Change Model: A Quality Improvement Study from Qatar

Abstract Introduction: The increased demand for birth registration (BR) services at the Birth Registration Unit (BRU), under the Ministry of Public Health in Qatar, and the negative media criticism called for an urgent quality improvement (QI) plan to be conducted. Methods: A QI project was carried out to improve the process of birth certificate registration in the country. This project depended on Kotter's eight-stage model as a guide for the aspired transformation. Thus, strengths, weaknesses, opportunities, and threats (SWOT) analysis, “straw-man” process map, root cause analysis, political, economical, social, technological, environmental and legal (PESTLE) factor analysis, and operational analysis of the BR process were attempted through cooperation and one–one interviews with service providers and stakeholders. The baseline measurements involved in the project focused on two main outcomes: client satisfaction and the cycle time of the BR process. Results: The post-change customer satisfaction survey showed higher overall satisfaction (0.66% overall dissatisfaction) with the services compared to the pre-change client satisfaction survey (17.3% overall dissatisfaction). Moreover, the calculated cycle time of the redesigned process (6.30 min) represented a substantial decrease as compared to the pre-change cycle time (almost 7 days). Conclusion: The study of the BR process revealed many facts regarding delays and wasted time. It served as a trigger for the change and made solving this problem much easier by examining the real underlying factors. In addition, the successful use of Kotter's change model at the BRU serves as a potential source for the diffusion of such model across other health institutions.

Management of public healthcare facilities in the Philippines: issues and concerns

Background/Aims Public hospitals are the primary means of healthcare delivery in developing countries. Given the pressing need for efficient health services, it is imperative to know the extent to which a country's public healthcare institutions meet an ever increasing public demand. This study aimed to assess the state of hospital facilities among public health care institutions in a developing country. Methods Descriptive research methods were used, including needs analysis along with management and client satisfaction surveys, in order to analyse information on issues that related to the management of hospital facilities in the Philippines. Various members of the hospital community were selected to assess different aspects of hospital management. Results The results of this study show that most concerns stemmed from the lack of financial resources, materials, equipment and technological innovations; insufficient knowledge, skills and human resources; and problems that related to processes and methodologies. Conclusions Public hospitals are in dire need of facility upkeep to maintain their operations. This has become a more pressing concern because of the very limited resources at the disposal of public hospitals. This study also highlighted the crucial role played by the national government in finding effective and efficient ways to address these issues and concerns to ensure successful delivery of healthcare services in the country.

Do vendors’ service models maximise value for clients?

This paper takes the form of a panel discussion, being an extended version of one that took place at Global Custody Forum in London in December 2018. It examines where service providers are as regards having service models that truly serve their clients, with asset managers and asset owners sharing their experiences and examining how things have evolved in the past five years. While there is hope that such vendors might develop the skill set expected of a professional services firm, there is a fundamental drag with providers not truly appreciating their shortfalls and not taking the baton to drive service-quality improvement. Often alone in the driving seat, asset managers and owners must focus internal resources to pinpoint where improvement is required and look beyond outmoded traditional client satisfaction surveys to more rigorous in-house and external tools. This paper rounds off with a broader perspective on firms’ current initiatives for attaining operational excellence both in-house and at their vendors.

Relationship Between Perceived Nurse Caring and Patient Satisfaction in Patients in a Psychiatric Acute Care Setting.

Patients admitted to psychiatric acute care settings benefit from interactions and caring relationships with hospital staff. The current study describes the association between patients' perceptions of nurse caring and their satisfaction with care at an inpatient psychiatric-mental health unit. The relationship between patients' perceptions of nurse caring and two measures of satisfaction with care were explored. A convenience sample of patients (N = 169) completed the Caring Behaviors Inventory-16 and Client Satisfaction Survey. Data were collected at the time of discharge from the hospital. The associations between perceived nurse caring and satisfaction with care and overall satisfaction with care resulted in strong, positive, statistically significant correlations. Treating patient information confidentially and giving treatments and medications on time were highly ranked, along with feeling safe during the hospitalization and satisfaction with nursing care. Additional research on patients' perception of nurse caring and satisfaction with care is needed. [Journal of Psychosocial Nursing and Mental Health Services, 57(7), 29-38.].

P188 The Process Evaluation of Bobcat Bounty: A Campus Pantry Intervention

Background College food insecurity affects academic performance and as well as mental and physical health. In response, many universities have created on-campus food pantries. A total of 40% of Texas State students reported diminished food security that may be due to lack of access to acceptable food, knowledge of resources, or environmental factors. This project aims to evaluate the first year of implementation and the initial impact of the on-campus food pantry, Bobcat Bounty. Objective To examine the key factors necessary to support and sustain an on-campus food pantry. Study Design, Settings, and Participants The following strategies were used to evaluate the implementation of Bobcat Bounty: surveys and interviews with college student pantry clients, volunteer observations, student awareness surveys and intercept interviews, process evaluations of inventory data, and in-depth interviews with faculty/administrators serving on the steering committee. Measurable Outcome/Analysis Participant surveys and interviews assessed level of food security, environmental determinants for food security, and nutrition knowledge among participants. Descriptive analysis of survey data was performed in SPSS. Interviews were transcribed and coded for key constructs, such as characteristics of health champions, self-efficacy, social support, reinforcing factors, and sustainability. Results Participant surveys and interviews demonstrated the impact of Bobcat Bounty on participant food security, nutrition knowledge, and attitudes regarding community/university support. Results from volunteer observations and client satisfaction surveys yielded key indicators of pantry sustainability. Stakeholder interviews provided descriptions of support, self-efficacy, and leadership. Conclusion The evaluation of the on-campus food pantry resulted in the identification of key factors for sustained institutional support and the effectiveness of the pantry model. Funding Texas State University.

Same-Day HIV Pre-Exposure Prophylaxis (PrEP) Initiation During Drop-in Sexually Transmitted Diseases Clinic Appointments Is a Highly Acceptable, Feasible, and Safe Model that Engages Individuals at Risk for HIV into PrEP Care.

ObjectiveStrategies to increase pre-exposure prophylaxis (PrEP) uptake are needed. We hypothesized that same-day PrEP initiation in a sexually transmitted diseases (STD) clinic would be acceptable, feasible, and safe, and that individuals would engage in ongoing PrEP care.MethodIndividuals aged ≥ 18 years were evaluated for PrEP. Exclusion criteria were HIV, history of renal dysfunction or chronic hepatitis B infection, pregnancy, indications for HIV post-exposure prophylaxis, or positive screen for acute HIV symptoms. One hundred individuals received a free 30-day PrEP starter pack and met with a patient navigator to establish ongoing care. Bivariate analysis and multivariable logistic regression were used to compare individuals who did and did not attend at least 1 PrEP follow-up appointment within 180 days of enrollment. Client satisfaction surveys were given 3 months after enrollment.ResultsThe majority (78%) of participants completed at least 1 PrEP follow-up appointment, and 57% attended at least 2 follow-up appointments. After adjusting for race and ethnicity, age, health insurance status, and annual income, only income was associated with follow-up appointment attendance. Each additional $10,000 increase in income was associated with a 1.7-fold increase in the odds of attending a PrEP follow-up appointment (95% confidence interval, 1.07–2.66, P = .02). The majority (54%) of individuals completed the satisfaction survey and all respondents liked the option of same-day PrEP initiation.ConclusionsOur study suggests STD clinic-based, same-day PrEP initiation is acceptable, feasible, safe, and links a high proportion of individuals into ongoing PrEP care. Additional resources may be needed to support low-income individuals’ retention in care.

Food Is Medicine: Providing Medically Tailored Meals to Community Members with Disease-associated Nutritional Risk Supports Stable BMI and Decreased Hospitalization (P12-005-19)

ObjectivesMANNA, a Food is Medicine organization in Philadelphia, provides nutritional support for community members at nutritional risk from serious illness. MANNA’s program of medically-tailored meals and nutrition counseling have been associated with lower healthcare utilization and costs, however the specific health outcomes that contribute to these effects are unknown. The objective of this research is to analyze change in body mass index (BMI) and proportion of recent hospitalizations in association with MANNA’s program. MethodsA retrospective chart review was conducted for 103 clients who answered a 2016 Client Satisfaction Survey and received at least six months of MANNA’s program between Jan. 2015 and Dec. 2016. Data from the start of services and at 6-months follow-up were entered into Research Electronic Database Capture (REDCap) and analyzed using Statistical Analysis Software (SAS). ResultsThe median age of clients in the sample was 66.0 years (interquartile range (IQR) 58.0—72.0). Primary diagnoses were cancer (53%), renal disease (15.7%), diabetes (7.8%), HIV/AIDS (3.9%), heart disease (3.9%) and “other” (16.7%). Half of the sample (52.0%) reported having insufficient money to buy food. Per weight history, two-thirds (63.3%) of clients had decreasing weight before program enrollment, 28.9% had stable weight and 7.8% had increasing weight. Change in BMI between initial intake and recertification was: median = 0.04; IQR (–0.84,–1.02). Analysis of variance followed by a multiple comparisons with a Bonferroni adjustment found no evidence of any difference in BMI change between diagnoses. Bivariate analysis with t-tests found no evidence of any difference in BMI change between clients with enough money for food and those without (P = 0.4277). McNemar’s Test found evidence of a significant decrease in the proportion of clients who had recent hospitalizations at follow-up compared to the start of services (P = 0.0077). ConclusionsManna’s program was associated with stable BMI. Change in BMI was not significantly different based on primary diagnosis or insufficient money to buy food. The proportion of client hospitalizations was significantly less after MANNA’s program. Stabilization of BMI is a possible health outcome that contributes to lower healthcare utilization and cost savings in MANNA’s clients. Funding SourcesNone.

Between Early Prevention and Statutory Intervention: Meeting the Needs for Targeted Support for Children and Families

<em>The subject is services for vulnerable children aged up to fourteen years and their families in the Winchester area of southern England. The services comprise three group-work based programmes, each lasting for twelve months. Their review comprised a two stage study designed to scope future objectives for a host charity in its development alongside faith agencies. The first stage used a Delphi process to define the principal priorities of trustees. These were then rated and applied to a follow up client satisfaction survey across the three programmes for 40 families. The overall 55% rate indicated a positive response from service users with a multi-dimensional approach to resilience building strongly endorsed. However, the analysis also scoped three areas for improvement. Findings indicated first, that the significance of help with preparation for work and education is understated by trustees less familiar with employment shortfalls; secondly that family focused services should recognize the particular needs of fathers and not be slanted towards mothers and their children; and thirdly, decisions on social enterprise status must take into account potential disconnects between the values of service recipients and those of different socio-economic means in governance roles. These findings are relevant to comparable voluntary sector agencies.</em>

Popular Musician Responses to Mental Health Treatment.

Popular (i.e., nonclassical) musicians have higher rates of mental health disorders and mental health service utilization than the general population. Little is known, however, about how popular musicians perceive mental health interventions in terms of overall satisfaction and therapeutic benefit. An online client satisfaction survey was sent to all musicians and family members who received mental health services through a nonprofit mental health organization in Austin, Texas, between July 2014 and June 2015 (n=628). 260 individuals (41.4%) responded to the survey, of whom 94% (n=244) were musicians. A majority of musician respondents were male (60%) and white (82%). 87% received counseling, 32% received psychiatric medication treatment, and 8% received addiction recovery services. 97% of musicians (205/211) rated their counselor as 'very good' or 'excellent,' 88% (64/79) rated their psychiatric providers as 'very good' or 'excellent,' and 94% (17/19) rated their addiction recovery specialists as 'very good' or 'excellent' (nonsignificant between all categories, p>0.05). 89% of musicians receiving counseling, 84% receiving psychiatric medication treatment, and 95% receiving addiction recovery services agreed or strongly agreed that their symptoms and overall functioning improved as a result of their treatment (nonsignificant between all categories, p>0.05). Popular musicians express strong provider satisfaction and overall benefit when mental health interventions are accessible, affordable, and delivered by professionals familiar with their concerns. More research is needed to understand the unique psychosocial stresses popular musicians face to inform treatment planning for this high-risk, underserved population.

Preserving Dignity in the Face of Hunger

Hunger in the United States has become commonplace. Food pantries are now regularly used by millions of people. Once thought to be used by the destitute, today they are frequented by families, students, the elderly people who hold full-time jobs, and people who thought they would never have to seek assistance to have enough to eat. Viewing food pantries as a major foodways resource, this study focuses on how a New England food pantry seeks to give not just food but also integrity, respect, and hope. It employed a client satisfaction survey as part of an evaluation of the effectiveness of their food pantry and used the data for organizational transformation. This study shows how organizations can destigmatize the requesting food process and provide services in a humane way that treats hungry people as neighbors and friends, not burdens and failures.

The unintended consequences of community verifications for performance-based financing in Burkina Faso

Performance-based financing (PBF) is being widely implemented to improve healthcare services in Africa. An essential component of PBF involves conducting community verifications, wherein investigators from local associations attempt to trace samples of patients. Community surveys are administered to patients to verify whether healthcare workers reported fictitious services to increase their revenue. At the same time, client satisfaction surveys are administered to assess whether patients are satisfied with the services received. Although some global health actors are concerned that PBF can trigger unintended consequences, this topic remains neglected. The objective of this study was to document the unintended consequences of community verification. Guided by the diffusion of innovations theory, we conducted a multiple case study. The cases were the catchment areas of seven healthcare facilities in Burkina Faso. Data were collected between January 2016 and May 2016 using non-participant observation, 92 semi-structured interviews, and informal discussions. Participants included a wide range of stakeholders, such as community verifiers, investigators, patients, and healthcare providers. Data were coded using QDA Miner, and thematic analysis was conducted. Healthcare workers did not significantly disturb or try to influence community verifiers during patient selection for community verifications. Unintended consequences included stakeholders’ dissatisfaction regarding compensation modalities, work overload for community verifiers, and falsification of verification data by investigators. Community verifications led to loss of patient confidentiality as well as fears and apprehensions, although some patients were pleased to share their views regarding healthcare services. Community verifications also triggered marital issues, resulting in conflicts with, or interference from, husbands. The numerous challenges associated with locating patients in their communities led stakeholders to question the validity and utility of the results. These unintended consequences could jeopardize the overall effectiveness of community verifications. Attention should be paid to these unintended consequences to inform effective implementation and refine future interventions.

Client satisfaction in a faith-based health network: findings from a survey in Uganda.

Client satisfaction surveys are important in evaluating quality of the healthcare processes and contribute to health service improvements by assisting health program managers to develop appropriate strategies. The goal of this study was to assess clients' level of satisfaction with services provided by private-not-for-profit member health facilities affiliated to Uganda Protestant Medical Bureau. This was a cross-sectional descriptive study using an interviewer-administered questionnaire conducted in 254/278 (91%) of UPMB member health facilities between 27th April and 14th July 2014 among 927 clients. The tool measured ten dimensions of the care-seeking experience namely; health facility access; waiting time; health providers; support staff; rights; payments; facilities and environment; consent; confidentiality; and the overall care seeking experience. Logistic regression was utilised for multivariate analysis. Overall client satisfaction was found to be high within the UPMB network (84.2%). Most of the client satisfaction dimensions were rated above 70% except payments and rights. There was evidence of association with marital status; single/never married were 3.05 times more likely to be dissatisfied compared to widowed. Clients attending HCIII were less likely to be dissatisfied compared to those attending HCII (OR=0.51, 95% CI: 0.25-1.05). Post-secondary education (OR=1.79; 95% CI 1.01-3.17), being formally employed (OR=2.78, 95% CI: 0.91-8.48) or unemployed (OR=3.34, 95% CI: 1.00-11.17), attendance at a hospital (OR=2.15, 95% CI: 1.36- 3.41) were also associated with high dissatisfaction levels with payments. This study found a high level of satisfaction with services in the UPMB network but recorded low client satisfaction with the dimensions of rights and payments. Health workers should take time to explain rights and entitlement as well as charges levied to clients.