| dc.description | There is no reliable information on the quality of care offered in health units in Mukono District. This study was therefore carried out to provide the DHT with information for targeting improvements in quality of care. The study objectives were to, i) assess patient satisfaction with quality of care provided in health units in Mukono District, ii) assess the quality of the process of health care delivery in health units in Mukono District, iii) assess health care provider prescribing behavior using treatment of malaria in children under five years as a proxy indicator, and iv) determine factors that influence delivery of quality health care among health care providers in Mukono District. A descriptive cross sectional study was done. A stratified sample of eighteen health units was selected. Three hundred and eighty seven patients were interviewed to assess satisfaction with the quality of health care. To assess the process of health care delivery, 18 health care providers were observed attending to three sick under five year old children each. Health care provider prescribing behavior was assessed retrospectively by a review of records of malaria treatment in children under five years old. Three hundred and eighty four records of previous six months were reviewed. Factors affecting delivery of quality care by health care providers was assessed by use of key informant interviews. The results on patient satisfaction revealed that 15.5% (60/387) of patient respondents were completely satisfied with the overall quality of care provided in the health units. Eighty percent (311/387) were satisfied, 4% (14/387) were dissatisfied and 0.5% (2/387) were completely dissatisfied. The quality of the process of care was assessed using a scoring system. At a cut off mark of 60% of the expected total score, only 35.2% of the children were managed adequately. This study also found that on average, 3.2 drugs were dispensed to each child with malaria and 41.8% received antibiotics. Eighty five percent received an injection and only 48.3% were treated according to NSTG. The key informants thought that factors that contribute to quality health care were availability of drugs and equipment, adequate staffing with trained personnel, regular effective support supervision, and motivation of health care providers. From the findings of this study, it may be concluded that patients are generally satisfied with the quality of health care provided in the health units of Mukono District. However technical competence of health care providers does not reach required standards. It is therefore recommended that the DHT of Mukono District focus training of health care providers on clinical case management of common childhood illnesses and rational drug use. | |
