A multidimensional study of public satisfaction with the healthcare system: a mixed-method inquiry in Ghan
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Date
2021
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BMC
Abstract
Background: Many governments in sub-Saharan Africa have recently sought to improve their health systems by
increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known
about the impact of these intended improvements on public perceptions about the healthcare systems. This article
examines whether and why people of diferent socioeconomic and ideological backgrounds are satisfed (or not) with
the current healthcare system in Ghana from a social ecological perspective.
Method: Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018.
We used ordinal logistic regression and thematic analysis techniques to analyse the data.
Results: Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors
(e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital);
community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health
system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with
the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health
personnel, fnancial constraints, perceived poor health facilities, and perceived inefcacy of services contribute to dis‑
satisfaction with the healthcare system.
Conclusion: Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological
perspectives by considering factors such as demographic profle, health needs, political orientation, issues of trust in
the healthcare system, and the dynamics and impact of social relationships of populations concerned.
Description
This article is published by BMC, 2021 and is also available at https://doi.org/10.1186/s12913-021-07288-1
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Citation
BMC Health Services Research (2021) 21:1320