Patients' perceptions of primary health care services in the Eastern Cape, South Africa

Abstract

Seeking to understand patient perspectives is an important step in the efforts to improve the quality of health care. The purpose of this study was to examine patient satisfaction with primary health care (PHC) services. A purposive sample of 19136 patients aged 18 years and above was interviewed at 266 PHC clinics in three selected districts of the Eastern Cape, South Africa. Interviews with respondents were conducted before they exited the clinic. Majority of the respondents were African (97.9%), female (76%), aged 50 years or less (69.4%) and were unemployed (92.7%). Nine in 10 (90.1%) had none, a little or a moderate amount of money to meet their needs and more than one in five did not have any formal education (21.7%). Almost half of the respondents (49.7%) reported to have gone to the clinic for the treatment of diseases they did not disclose. The study revealed notable differences in patient satisfaction between male and female patients across the various domains such as access, assurance, empathy, general satisfaction and tangibles. Within domains, significant gender differences were observed on selected items. Suggested health services' improvements included the improvement of the quality of basic amenities, more health care staff, improved communication, respect for patients' dignity and the availability of medicines. We conclude that quality improvement and research into the primary health care of women could benefit from gender analysis of patient satisfaction data and from more gender-sensitive patient satisfaction measures.