Community Perception And Client Satisfaction About The Primary Health Care Services In A Tribal Setting Of Gujarat - India

摘要

This community based cross sectional study attempts to assess the community perception and client satisfaction of primary health care services provided by Primary Health Centre (PHC) of Panchmahal district of Gujarat to assess the awareness of the community about primary health care services and its utilization in a tribal area and to assess the client satisfaction of those who have utilized the services. This study was conducted from January 2009 to March 2009. For the community survey, two blocks were randomly chosen and the interview was carried out by house visits. For exit interviews, patients were selected randomly from those attending the primary health centre. A total of 479 interviews were conducted. It was seen that 82% were aware of the availability of primary health centre but more than two-thirds preferred quacks. Approximately two-thirds to three-fourths of the clients were satisfied with the primary health care services. Introduction The health sector occupies an enormously important position in ensuring sustainable overall socio-economic advancement in developing countries. In the way of providing primary health care services, the Government of India has made impressive growth in terms of the establishment of primary health care institutions across rural, tribal hard-to-reach sectors. However, shortcomings in the delivery of primary health care services has resulted in lesser utilization rates .The delivery of health services for the poor people in tribal areas and disadvantaged population remains a challenge in India. All healthcare providers and programmes in our country have overwhelming emphasis on quantitative aspect of service delivered, which means that, in a quest to chase runaway targets, we neglect the concept of quality of care, which is also a right of clients (1). Healthcare providers and programmes worldwide have increasingly recognized that the quality of care they provide determines their overall success in attracting the clients and meeting their needs, and the quality improvement initiative has been started because poor quality is costly - to clients, to programmes and to the society overall. People’s perception about quality of care often determines whether they seek and continue to use services (2). Being intangible in nature, the perception directly affects the quality rating in service. So, there are attempts to scale and measure this perception. Primary health care is the window to any health system and primary health care indicates the quality care of health system reflected by patient’s perception in terms of satisfaction to the services they are provided. A concern for patient satisfaction has been taken up by many health care authorities worldwide with the aim of responding to the client’s needs when addressing the issue of quality improvements in primary health care services. It is easier to evaluate the patients’ satisfaction towards the service than evaluate the quality of medical services that they receive. Therefore, a research on patient satisfaction can be an important tool to improve the quality of services.While the efforts are in the right direction, the public health sector is plagued by uneven demand and perceptions of poor quality. Countrywide, the underutilization of available facilities is of significant concern. The unavailability of doctors and nurses, as well as their negative attitudes and behaviours, are major hindrances to the utilization of primary health care services. The situation is further compounded by lack of drugs, and long travel and waiting times. What is particularly disturbing is the lack of empathy of the service providers, their generally callous and casual demeanour, their aggressive pursuit of monetary gains, their poor levels of competence and, occasionally, their disregard for the suffering that patients endure without being able to voice their concerns—all of these service failures are reported frequently in the print media. Such failures can p