Towards patient-centred care in Ghana: health system responsiveness, self-rated health and experiential quality in a nationally representative survey.

Journal: BMJ open quality

Volume: 9

Issue: 2

Year of Publication: 2021

Affiliated Institutions:  Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States hratcliffe@ariadnelabs.org. Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States. Division of Policy, Planning, Monitoring and Evaluation, Ghana Health Service, Accra, Greater Accra, Ghana. Harvard Global Health Institute, Harvard University T.H. Chan School of Public Health, Cambridge, Massachusetts, USA. Ghana Health Service, Accra, Greater Accra, Ghana. Department of Population, Family and Reproductive Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.

Abstract summary 

Person-centredness, including patient experience and satisfaction, is a foundational element of quality of care. Evidence indicates that poor experience and satisfaction are drivers of underutilisation of healthcare services, which in turn is a major driver of avoidable mortality. However, there is limited information about patient experience of care at the population level, particularly in low-income and middle-income countries.A multistage cluster sample design was used to obtain a nationally representative sample of women of reproductive age in Ghana. Women were interviewed in their homes regarding their demographic characteristics, recent care-seeking characteristics, satisfaction with care, patient-reported outcomes, and-using questions from the World Health Survey Responsiveness Module-the seven domains of responsiveness of outpatient care to assess patient experience. Using Poisson regression with log link, we assessed the relationship between responsiveness and satisfaction, as well as patient-reported outcomes.Women who reported more responsive care were more likely to be more educated, have good access to care and have received care at a private facility. Controlling for respondent and visit characteristics, women who reported the highest responsiveness levels were significantly more likely to report that care was excellent at meeting their needs (prevalence ratio (PR)=13.0), excellent quality of care (PR=20.8), being very likely to recommend the facility to others (PR=1.4), excellent self-rated health (PR=4.0) and excellent self-rated mental health (PR=5.1) as women who reported the lowest responsiveness levels.These findings support the emerging global consensus that responsiveness and patient experience of care are not luxuries but essential components of high-performing health systems, and highlight the need for more nuanced and systematic measurement of these areas to inform priority setting and improvement efforts.

Authors & Co-authors:  Ratcliffe Hannah L HL Bell Griffith G Awoonor-Williams Koku K Bitton Asaf A Kim June-Ho JH Lipstiz Stuart S Macarayan Erlyn E Ofosu Anthony A Otupiri Easmon E Schwarz Dan D Hirschhorn Lisa R LR

Study Outcome 

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Statistics
Citations :  Kruk ME, Gage AD, Arsenault C, et al. . High-Quality health systems in the sustainable development goals era: time for a revolution. Lancet Glob Health 2018;6:e1196–252. 10.1016/S2214-109X(18)30386-3
Authors :  11
Identifiers
Doi : e000886
SSN : 2399-6641
Study Population
Women
Mesh Terms
Adolescent
Other Terms
global health;patient satisfaction;patient-centred care;quality measurement
Study Design
Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Ghana
Publication Country
England