CLIENTS' SATISFACTION WITH IMMUNIZATION SERVICES IN THE URBAN AND RURAL PRIMARY HEALTH CENTERS OF ENUGU STATE, NIGERIA
The World Bank has severally advised developing countries to ensure that their health services are client oriented as clients’ satisfaction with healthcare services in Africa, remain one of the most important factors determining its utilization. The study was conducted to determine clients’ satisfaction with immunization services in the urban and rural primary health centers of Enugu state, Nigeria.
METHODS:
A cross-sectional analytical study design was used. A three stage sampling method was used to select 800 clients who presented with their children/wards to18 of the 440 primary health centers in the state. The clients were interviewed using an adapted questionnaire. Client’s composite index of satisfaction with immunization services, denoted as true satisfaction, was assessed by the proportion of clients who reported being satisfied with immunization services received on the day of data collection, and were also ready to use the health center again for immunization services, in addition to being willing to recommend the health center to others for same services. Data analysis was done using SPSS statistical software; version 15 and level of significance was determined at a value of less than 0.05.
RESULTS:
The mean age of the clients was 28.9±4.5, and 26.7±5.1 years in the urban and rural areas respectively. The major reason why the clients chose the primary health centers for immunization services was proximity to the health centers in the urban, (34.3%), and availability of vaccines in the rural area, (35.3%). Majority of the clients, 84.5% of those in the urban, and 94.3% in the rural were truly satisfied with the immunization services received. Long waiting time and uncomfortable waiting area were the major sources of dissatisfaction of the clients. Factors associated with client’s true satisfaction with immunization services included being a client in the urban area, (AOR=0.2, 95% CI: 0.1- 0.4), being married, (AOR= 35.1, 95% CI: 14.2- 86.9), and proximity to the health centers, (AOR= 2.6, 95% CI: 1.5- 4.3).
CONCLUSIONS:
Most clients were satisfied with immunization services in urban and rural primary health centres. However, there is the need to reduce the waiting time, and also improve on the physical conditions of the waiting area in the health centers to reduce dissatisfaction to services by clients.