HEALTH SYSTEM FACTORS INFLUENCING CLIENT SATISFACTION WITH ANTIRETROVIRAL THERAPY SERVICES IN PRIVATE HEALTH FACILITIES IN ABUJA, FCT

HEALTH SYSTEM FACTORS INFLUENCING CLIENT SATISFACTION WITH ANTIRETROVIRAL THERAPY SERVICES IN PRIVATE HEALTH FACILITIES IN ABUJA, FCT

CHAPTER ONE -INTRODUCTION
1.1 Background
New technologies in medicine offer the promise of increasing longevity, improving health and alleviating pain and suffering.As medical science and technology have advanced, and patient management have become more complex, there has been a concordant increase in the need for health care systems to provide consistently high quality care.Institute of Medicine(IOM) defined quality as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. The World Health Organization(WHO) 2007 Framework for Action for strengthening health
systems in developing countries identified quality as one of the key drivers of improved health outcomes and greater efficiency in health service delivery.It is characterized as one of the four mediators (along with access, coverage and safety) that connect the health system building blocks to the health system outputs.Despite this acknowledgement of the critical role of quality of care in strengthening health systems, there are few descriptions of how to ensure high-quality health care in developing countries.Quality: a mediator of health system outputs. The process of providing care in developing countries is often poor and varies widely.Explanations for variation and low-quality care in the developing world include lack of resources, failure to align practitioner incentives and objectives, failure to measure clinical practice, or failure to link quality improvement to better health outcomes.Patient satisfaction has been defined as the patient’s ―personal evaluation of providers’ ability to successfully deliver care that meets patients’ expectations and needs‖.Clients’ satisfaction with treatment processes may influence and are influenced by treatment outcomes. Clients who are
not satisfied with a service may have worse outcomes than others because they miss more appointments, leave against advice or fail to follow through on treatment plans.8 Clients who do not do well after treatment may have less than favourable attitudes towards a treatment service, even if it was of high quality by other criteria.An IOM report specified six characteristics of a high quality medical care system:
i. safe – avoiding injuries to patients from the care that is supposed to help them
ii. effective – providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse),
iii. patient-centered – providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions,
iv. timely – reducing waiting and sometimes harmful delays for both those who receive and those who give care,
v. efficient – avoiding waste, in particular waste of equipment, supplies, ideas, and energy
vi. equitable – providing care that does not vary in quality because of personal characteristics, such as gender, ethnicity, geographic location, and socioeconomic status. Based on this description of high quality care, it has been observed that even where health systems are well developed and resourced; there is clear evidence that quality remains a serious concern. But limited data indicate that high-quality care can be provided even in environments with severely constrained resources. Funding for HIV response has reached unprecedented levels in recent yearincluding Nigeria. The public sector health facilities has been the main recipient of these funds and thus the major provider of HIV/AIDS services.11 A relatively unexamined aspect is the role of the private sector facilities in HIV/AIDS services. Understanding the current and potential contributions from the private sector is critical as the nature of the HIV/AIDS response evolves from emergency relief to long-term sustainability. A study of five Sub-saharan countries found an absolute increase in HIV resource consumption at both public and private hospitals, but larger increases in private hospitals.According to the latest national health accounts report for Nigeria, private health facilities are the most patronized type of health facilities.In many developing countries, when people seek treatment for an illness they visit a private health provider first.Many clients prefer
to visit private health facilities based on factors such as ease of geographic access, shorterwaiting periods, longer or more flexible opening hours, greater availability of staff.

HEALTH SYSTEM FACTORS INFLUENCING CLIENT SATISFACTION WITH ANTIRETROVIRAL THERAPY SERVICES IN PRIVATE HEALTH FACILITIES IN ABUJA, FCT

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