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

Background: 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. Methods: This was a cross-sectional descriptive study using an interviewer-administered questionnaire conducted in 254/278 (91%) of UPMB member health facilities between 27 th April and 14 th 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. Results: 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. Conclusion: 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. Keywords: Client satisfaction, faith-based health facilities, health services, quality improvement, Uganda