Clients' Perception of and Satisfaction with Quality of Directly Observed Treatment Short Course: A Comparative Study of Private and Public Health Facilities in Southwestern Nigeria.

BACKGROUND AND OBJECTIVES: One third of the world population are at risk of developing active tuberculosis (TB), resulting in significant mortality and morbidity. The reported low patronage in many TB clinics may not be unrelated to the quality of services received by clients. The objective of this study was to determine clients' perception of and satisfaction with quality of DOTs treatments in private and public health facilities in Oyo State.

MATERIALS AND METHODS: A descriptive cross sectional study among 410 eligible clients selected using the multistage sampling method was conducted in Oyo State. Research instrument used were a structured pre-tested interviewer-administered questionnaire. Data was analyzed using the SPSS software version 17.0.

RESULTS: Mean age of respondents was 39.0 + 0.68 years, 211(51.5%) were male while 199 (48.5%) were females. 321(78.3%) worked in public health facilities. Majority of the respondents, 385 (94.0%), had good perception of quality of DOTs treatment received. These include good perception of communication (96.0%); of quality of care (90.4%), and good perception of staff attitude among 93.9% of respondents About 97% of the respondents had good satisfaction with the quality of DOTs treatment received. Good satisfaction was found among 98.3% in terms of adherence counseling received, 98.7% on TB treatment received and 98.7%, on waiting time spent, and these were far higher among private than public health facilities. Statistically significant association was found between the type of facility attended by respondents and having adherence counseling service and waiting period experienced (P-values < 0.05). Having received services in a private health facility is the major predictor of favourable perception and good satisfaction with quality of DOTS treatment among respondents studied.

CONCLUSION: Though perception of and satisfaction with service delivery were good, this was better in private than in public; thus stressing the need for better monitoring and evaluation of services rendered by health care workers in order to encourage patronage by clients.