Quality of Primary Health Care during COVID-19 Pandemic in Addis Ababa Ethiopia: Patients-side and facility level assessment

Abstract

Abstract

Background: Quality is increasingly becoming an important aspect of health care that is given a priority nowadays. The assessment and assurance of quality depends on reliable evidence. It is evident that there is no comprehensive study related to quality of health care in public primary health care facilities during COVID-19 pandemic in Ethiopia. Even if the formulation and launching of health facility standards nationally has been made in 2013 and quality has been taken as one pillar for the past two decades, quality of health services has been poor. Unfortunately, the occurrence of COVID 19 pandemic poses another threat to the already existing poor quality of health service. Therefore, this assessment of selected quality dimensions of primary health care in Addis Ababa could be used for future monitoring and evaluation of quality improvement in the country as well as prepare the primary health facilities against possible future pandemics.

Objective: The objective of the study is to assess the selected dimension of health care quality at the time of COVID 19 in the selected primary health care facilities in Addis Ababa, Ethiopia

Methods: A facility-based cross-sectional study design was used. The study was done in six health facilities in Addis Ababa, Ethiopia. Patients, health service providers and health facilities were the study participants. An observation checklist and interviewer administered questionnaire were used to assess the routine service provision. Data cleaning, management and analysis was done using SPSS version 23 statistical software. Both descriptive and analytical results were used to present the findings.

Result: The overall patient satisfaction was 77.9 %. From the quality dimension, the grand mean satisfaction score for health service accessibility, patient centeredness, equitability, and timeliness were54.7%, 67.9%, 72.1%, 63.4% respectively. From the facility level analysis only two facilities indicated employees receive ongoing Continuing Professional Development (CPD). All the facilities maintain employment record of each staff; however, with regard to the content only two facilities contain credential information, health examination record, in-service education /training and copies of annual evaluation. In half of the facilities lack of procedure room and hand washing room was observed. Toilets were not clean. Poor continuity of care was also identified and only two facilities indicated they had feedback providing mechanism in the referral system.

Conclusion: Most of the respondents were satisfied with the quality of primary health care service. Gaps, however, were identified in the human resource management, infrastructure, referral system and continuity of care from the facilities’ perspective. Incomplete recording of most of the content of employee was identified as well. Thus, it is recommended to improve the identified challenges through provision of a system (guideline), continuous supervision, mentorship, and training. [Ethiop. J. Health Dev. 2021; 35(SI-1):98-107]

Keyword: quality of service, patient satisfaction, continuing professional development