Patient satisfaction at the Muhimbili National Hospital in Dar es Salaam, Tanzania.

OBJECTIVES: Patients are the primary beneficiaries of the services and care that hospitals provide. The Patient Satisfaction study examined the extent to which patients at the Muhimbili National Hospital (MNH) were satisfied with the services and care they received at MNH. This was part of a baseline study that sought to determine the level of performance of the hospital before massive restructuring, reform, and renovations were undertaken. METHODOLOGY: Exit interviews were the main research method used to determine patient satisfaction. Patients were interviewed as they were leaving the OPD clinics, laboratory, X-ray, pharmacy and inpatient wards. RESULTS: The study found that most patients were satisfied with the services and care they received. This high level of satisfaction must be viewed within the context of a hierarchical public health care delivery system, with MNH at the apex. The services and care MNH provides can only be excellent compared to that provided by lower level health facilities. Indeed, patients covered by this study perceived the services provided by MNH as superior, and this was reflected in the high level of satisfaction they reported. Some patients expressed dissatisfaction with specific aspects of the services that they received. They were particularly dissatisfied with long waiting times before receiving services, the high costs of treatment and investigations charged at MNH, poor levels of hygiene in the wards, and negative attitudes of staff towards patients. CONCLUSION: Although only a small proportion of patients expressed dissatisfaction with these aspects of the services provided, they are significant in that they constitute a call for action by the MNH management to encourage the health personnel to embrace a new staff-patient relationship ethos, in which the patient is a viewed as a customer.

Attitudes and perceived impact of antiretroviral therapy on sexual risk behaviour among young people in Kahe, Moshi Rural District, Tanzania.

Free antiretroviral therapy (ART) has been provided through the public health system in Tanzania since 2004. The success of national ART roll out programme is premised upon collaborative efforts of health systems, communities and policy environment. However, community perceptions of ART and its implications on sexual behaviours and HIV/AIDS prevention remain largely unknown. Drawing on focus group discussions with young people, this paper examines perception about ART and the potential impact of antiretroviral therapy on risk sexual behaviour in rural Tanzania. Participants included a purposively selected sample of males and females aged 14-24 years. Results show that young people were both optimistic and concerned regarding availability of ART. Positive attitudes toward ART were associated with public health significance of therapy in managing opportunistic infections and extending lives of HIV infected persons. However, the positive outcomes of therapy were considered to be short lived, unsustainable and potentially threatening to the sexual health and wellbeing of HIV negative members in the community. ART was considered to empower infected persons to intentionally spread HIV to uninfected individuals in the community through deliberate unprotected sexual activities. The study highlights the significance of reinforcing HIV prevention while underscoring the need to provide appropriate information and increasing access to ART in rural areas of Tanzania. In conclusion, creating a therapy friendly atmosphere through information delivery is crucial in promoting social acceptability of antiretroviral therapy among youths. Efforts to improve access to antiretroviral drugs should re-emphasize prevention counselling to minimize sexual transmission of HIV.

Patient Satisfaction at the Muhimbili National Hospital in Dar Es Salaam; Tanzania

Objectives: Patients are the primary beneficiaries of the services and care that hospitals provide. The Patient Satisfaction study examined the extent to which patients at the Muhimbili National Hospital (MNH) were satisfied with the services and care they received at MNH. This was part of a baseline study that sought to determine the level of performance of the hospital before massive restructuring; reform; and renovations were undertaken. Methodology: Exit interviews were the main research method used to determine patient satisfaction. Patients were interviewed as they were leaving the OPD clinics; laboratory; X-ray; pharmacy and inpatient wards. Results: The study found that most patients were satisfied with the services and care they received. This high level of satisfaction must be viewed within the context of a hierarchical public health care delivery system; with MNH at the apex. The services and care MNH provides can only be excellent compared to that provided by lower level health facilities. Indeed; patients covered by this study perceived the services provided by MNH as superior; and this was reflected in the high level of satisfaction they reported. Some patients expressed dissatisfaction with specific aspects of the services that they received. They were particularly dissatisfied with long waiting times before receiving services; the high costs of treatment and investigations charged at MNH; poor levels of hygiene in the wards; and negative attitudes of staff towards patients. Conclusion: Although only a small proportion of patients expressed dissatisfaction with these aspects of the services provided; they are significant in that they constitute a call for action by the MNH management to encourage the health personnel to embrace a new staffpatient relationship ethos; in which the patient is a viewed as a customer