Health Policy & Management

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Start date: 2012End date: 2015

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    PATIENTS’ SATISFACTION WITH CLINICAL LABORATORY SERVICES IN A SECONDARY HEALTH CARE FACILITY, ONDO WEST LOCAL GOVERNMENT AREA, NIGERIA
    (2015-04) THOMAS, J. Y.
    Patients’ satisfaction with clinical laboratory services is essential as laboratory service plays a key role in patient management. Under-utilisation which could be due to dissatisfaction of clinical laboratory services can contribute to a worsened state of morbidity or mortality among patients. Information on satisfaction with clinical laboratory services is essential for policy and development of interventions to improve patient’s satisfaction. This study was therefore conducted to assess patients’ satisfaction with the clinical laboratory services in a secondary health care facility in Ondo West Local Government Area, Ondo State. Using a cross-sectional study design, 426 patients utilising clinical laboratory services of the General Hospital, Ondo were recruited, using a systematic sampling technique. Respondents’ information was collected using pre-tested, semi-structured, interviewer-administered questionnaire. The questionnaire was used to obtain information on socio-demographic characteristics and satisfaction with the domains of clinical laboratory services (accessibility, hygiene of the environment, patient waiting time, patient-provider communication, availability of requested tests, and availability of laboratory space, competence and attitude of laboratory staff). Using the 50th percentile as cut-off, patients were classified as satisfied if they scored 50th percentile and above, while those scoring less than the 50th percentile were classified as dissatisfied. Chi-square test was used to determine the relationship between independent variables (sex, marital status, educational level) and the level of patients’ satisfaction. Logistic regression was used to determine predictors of patients’ satisfaction with the clinical laboratory services; level of significance was set at 5%. Respondents’ mean age was 34.7+12.4 years. Most of the respondents were females (62.4%), currently married (59.4%), Christians (87.1%), had secondary education (70.4%) and self-employed (51.4%). Majority of the respondents were satisfied with the confidentiality attached to the result of their tests (89.7%), the cost of the laboratory tests (67.6%), competence of the laboratory staff (78.0%), patient waiting time (81.9%) and the environmental hygiene of the laboratory (68.1%). Respondents also expressed satisfaction with the availability of space in the laboratory (84.5%), the availability of required tests (87.9%), patient-provider communication (77.2%), the respect and courtesy shown by laboratory staff (82.6%) and accessibility of the laboratory (71.8%). Overall, 79.0% of the patients were satisfied with clinical laboratory services. A significantly higher proportion of respondents who were males (61.6%), not married (64.6%) and had tertiary education (70.4%) were satisfied with the clinical laboratory services. Being male was found to be a predictor of patients’ overall satisfaction with clinical laboratory services (OR: 2.1; 95% CI: 1.1-4.3). Other predictors were not married (OR: 2.6; 95% CI: 1.2-4.1) and having a tertiary education (OR: 4.3, 95% CI: 2.1-6.5). Patients’ satisfaction with clinical laboratory services in the secondary health care facility was high. Subsidising the cost of laboratory tests, and improving the environmental hygiene of the laboratory could further improve patients’ satisfaction.
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    AN APPRAISAL OF PRIMARY HEALTH CARE STAFFING SITUATION IN THE FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA
    (2012-07) IBRAHIM, CHRISTIANAH MORONWITAN
    Health personnel are central to the effective implementation of Primary Health Care (PHC). The Federal Capital Territory (FCT), Nigeria by virtue of its political status is expected to be a model regarding the effective implementation of PHC. One of the indicators of quality PHC implementation is adequate health manpower. This information with regard to the FCT is needed to ascertain the fulfillment of this expectation as a model. Hence, this study was conducted to assess Health Manpower availability in PHC facilities. A cross-sectional study was carried out among all the 809 health personnel in 180 PHC facilities in FCT. Population figure was obtained from national census, 2006. Data were collected with a pre-tested, structured, self-administered questionnaire which focused on respondents’ socio-demographic characteristics and their perception of personnel availability. In-Depth Interviews (IDI) were conducted with all heads of the six PHC departments. Four randomly selected PHC centres were visited for five consecutive days to record absentees using a register review checklist. Staff Population Ratio (SPR) was compared with the minimum standard set by the National Primary Health Care Development Agency (NPHCDA). Data analysis was done using descriptive statistics, Chi-square and thematic approach. Respondents’ mean age and years of work experience were 33±7.4 and 8.1±6.7 years respectively while 98.6% had post secondary education. The respondents included senior Community Health Extension Workers (CHEWs) (40%), junior CHEWs (23.3%), Nurse/Midwives (18.8%), Community Health Officers (CHOs) (5.0%), Laboratory Technicians (2.5%), Medical Record Officers (MROs) (1.7%) and, Medical Officers (1.4%). Others (7.1%) included Pharmacy Technicians, Environmental Health Officers, and Laboratory Scientists. The SPR per 100,000 population for various cadres were 1.0 Medical Officers), 3.2 (CHOs), 32.0 (senior CHEWs), 18.0 (junior CHEWs), 5.8 (Nurse/Midwives), 0.9 (MROs), 1.0 (Pharmacy Technicians) and 2.2 (Laboratory Technicians) compared with the NPHCDA minimum SPR of 2.3, 2.3, 24.6, 50.2, 9.1, 2.3, 2.2, and 2.0 respectively. Majority (69.5%) of the respondents perceived that health personnel were adequate in their health facilities. The IDIs revealed that services rendered met most of the patients’ requirements and lapses occasionally observed were due to lack of functioning equipments and frequent drug stock-outs. The respondents stated that opportunity for continuing education (60.3%), availability of working materials (53.3%), and matching skill to task (51.5%), substantially encouraged staff retention. Major reasons given by respondents for inadequate health personnel were lack of recruitment by the government (75.3%), non-provision of equipment (16.9%) and basic infrastructure (9.0%). Both IDI and observation revealed staff absenteeism was mostly due to ill health and lack of accommodation for staff. Absenteeism rate in the observed facilities was 10.7%. All PHC services except oral and mental health care were provided in observed health facilities. Availability of primary health care personnel in the Federal Capital Territory fell short of the minimum standard for most primary health care cadres. There is a need to plan for adequate primary health care personnel in the Federal Capital Territory to achieve comprehensive health care delivery.