Clients Centeredness of the Governmental Primary Health Care Services: Gaza Governorates
Date
2011-08-16
Authors
Huda Haidar Anan
هدى حيدر عنان
Journal Title
Journal ISSN
Volume Title
Publisher
Al-Quds University
Abstract
Universally, Primary Health Care (PHC) services are considered the vertebral
column of health care systems. Ideally, it is assumed that PHC services should be
responsive to people's needs and expectations. Client-centered PHC services could
meet the goal of being responsive through designing and providing health care
services that suit clients and guarantee appropriate accessibility, involvement in
the caring processes and the delivery of quality health care services.
A quantitative analytic cross-sectional study was conducted in order to assess the
extent to which the governmental PHC services are client-centered. The
instruments used in this study were exit interviews for 300 randomly selected
clients who received health care services from the 10 randomly selected PHC
clinics in the Gaza Governorates (GG), with a response rate of 91%. Another
questionnaire was used to capture general information about the investigated PHC
clinics. The researcher collected the data by herself with the help of two welltrained
data collectors. Validity and reliability measures such as standardisation
of data collection and data quality check and re-entry were assured. Reliability
consistency test was very high (Cronbach’s Alpha 0.9).
Clients' perceptions were good regarding physical, financial, technical and
information accessibility. Accessibility to essential medications was good but there
were gaps in the dispensing, labelling procedures and the constant availability of
drugs. Most of the clients were satisfied with the delivery of health care services
such as; waiting time, time spent with health care providers, communication,
respect and quality of basic amenities. Clients have low chances to select the
health care provider or to provide consent before undergoing medical procedures.
Clients were not adequately involved where most of the clients did not participate
in activities aiming to improve health care services. Three out of the ten (30%)
investigated PHC clinics reported having community committees with regular
meetings. Clients’ participation in deciding their treatment plans were perceived
as weak. Also, most of the clients did not participate in activities related to
evaluating the health care services they receive from the PHC clinics. The most
important factor that reflects good quality of health care services from clients
perspectives was the availability of drugs (67.3%), being respected by the health
care providers (46.5%) followed by being cured (34.6 %). Respondents from level
two and level three clinics, southern governorates clinics and clinics that had
community committees, elicited higher scores than their counterparts from other
clinics with statistically significant differences (P <0.05) between these groups.
Similarly, respondents with higher education level reported higher scores than
their counterparts with statistically significant differences between these groups
(P<0.05).
The study recommends adopting new policies that enhance the client centeredness
of the heath care services through increasing the awareness about basic clients’
health rights, increasing clients’ involvement in the planning, implementation and
evaluation of health services. Also, improving communication and interaction
between the clinics teams and the local communities is essential including
establishing community committees.