Soc Sci Med. 1994 Sep; 39(6): 767-80.

Community satisfaction with primary health care services: an evaluation undertaken in the Morogoro region of Tanzania.

Gilson L, Alilio M, Heggenhougen K.

Health Policy Unit, London School of Hygiene and Tropical Medicine, England.

Satisfaction is an important element of the quality of health care, often determining patient willingness to comply with treatment and influencing the effectiveness of care. However, few specific assessments of patient satisfaction in developing countries have been undertaken. This paper presents findings from such a study, carried out in Tanzania and primarily undertaken through the use of qualitative interviewing techniques. The study illustrates the perceived problems of the care available, such as structural and inter-personal skill failings, both of which were seen to influence drug availability and maternal services--key weaknesses of the available care. Health centres were perceived to be little better than dispensaries. Although church health care was generally perceived to be better than government care, there was considerable variation in community judgements and clear signs of poor quality church care. The use of villagers' own words and experiences brought into sharp focus the problems they experience in relation to health care and allow planning lessons are identified.