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Clinical communication and caregivers' satisfaction with child healthcare in Nepal: results from Nepal Health Facility Survey 2015
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition.ORCID iD: 0000-0002-8184-3530
2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, article id 17Article in journal (Refereed) Published
Abstract [en]

Background: Patient satisfaction is an important measure of quality of care and a determinant of health service utilisation and the choice of health facility. Measuring patients' experiences is important for understanding and improving the quality of care at health facilities. The aim of this study was to assess levels and identify associated factors of caregivers' satisfaction and provider-caregiver communication within child healthcare in Nepal.

Methods: Secondary analysis of Sick Child Exit Interviews (n=2092) sourced from 2015 Nepal Health Facility Survey data. Satisfaction was measured through caregivers' satisfaction with services received and their willingness to recommend the health facility visited. Communication indicators were chosen based on the 2014 WHO IMCI guidelines and aggregate communication scores were calculated based on the number of indicators acknowledged during assessments. Logistic regression was used for analysis.

Results: Although most respondents (82.1%) reportedly were satisfied with the care provided, only 35.9% experienced good communication with their providers. Caregivers who had ever attended school were more likely to be satisfied with services (1.44, CI 95% 1.04-1.99). Type of provider, sex of child or who the caregiver was had no association with caregivers' satisfaction. Having been given a diagnosis doubled the chances of satisfaction (AOR 2.04, 95% CI 1.38-3.00), as did discussion of the child's growth (OR 1.71, 95% CI 1.06-2.76) and having discussed any of the included topics (AOR 1.98, CI 95% 1.14-3.45).

Conclusions: Interventions to improve healthcare staff's communication skills are needed in Nepal to further enhance satisfaction with services and increase quality of care. However, this is an area that need further investigation given the high levels of satisfaction displayed despite poor communication. Other factors in the health care exchange between provider and clients are influencing the level of satisfaction and need to be identified and promoted further. High-quality care is no longer a goal for the future or only for high income settings; it is essential for reaching global health goals.

Place, publisher, year, edition, pages
BMC , 2019. Vol. 19, article id 17
Keywords [en]
Patient satisfaction, Patient communication, Child health, Nepal
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-375888DOI: 10.1186/s12913-018-3857-4ISI: 000455209900006PubMedID: 30621685OAI: oai:DiVA.org:uu-375888DiVA, id: diva2:1285272
Available from: 2019-02-04 Created: 2019-02-04 Last updated: 2019-11-21Bibliographically approved

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