Disappointed patients in Ghana

A recent study published in PloS One reveals that the quality of healthcare by Ghanaian providers is perceived a lot better by healthcare staff as compared to their clients. For example, health workers believe they are a lot more compassionate than perceived by their patients. The lead author of the article is Robert Kaba Alhassan, a PhD researcher within the NWO-WOTRO programme Global Health Policy and Health Systems.

The paper explores how quality of healthcare services provided by both public and private health facilities is perceived in order to identify reasons for clients' decisions to use certain healthcare providers and actively participate in health insurance schemes. The study found that there are wide gaps between client-perceived and provider-perceived 'technical' quality in the areas of:

• information provision to clients by health workers
• compassion/supportiveness of health workers
• staff respect for clients
• equal treatment for clients and waiting times

Improving health care outcomes

While many healthcare workers perceived these indicators to be satisfactory, clients generally expressed disappointment, suggesting communication gaps between clients and healthcare givers. Moreover, the study found that even though healthcare could technically easily be measured and improved, this did not greatly influence the perceptions of clients on service quality and willingness to utilize services of NHIA-accredited clinics.

The authors conclude that there is a need to intensify education for clients and frontline health workers on (perceived) components of healthcare quality to help bridge the existing gaps. Likewise there should be a balanced commitment to technical and perceived quality care by health managers and policy makers to help enhance client confidence in Ghana's healthcare system, promote efforts towards universal health coverage, and ultimately improve public health outcomes.

The paper

Lead author of the paper 'Comparison of perceived and technical healthcare quality in primary health facilities: implications for a sustainable national health insurance in Ghana' in Plos One magazine is Robert Kaba Alhassan, a PhD researcher with Noguchi Memorial Institute for Medical Research (NMIMR) at the University of Ghana Legon and with the Amsterdam Institute for Global Health and Development (AIGHD). Robert is doing his PhD with Tobias Rinke de Wit (promotor) and Nicole Spieker (co-promotor).The study was conducted in two coastal regions of Ghana among 324 health workers in 64 clinics accredited by the National Health Insurance Authority (NHIA) and in 1,903 households around the catchment area of the 64 clinics.

COHESiSION project

This WOTRO-COHEiSION Ghana Project was financially supported by The Netherlands government through the Ministry of Foreign Affairs and WOTRO Science for Global Development, a division of the Netherlands Organisation for Scientific Research (NWO), under the Global Health Policy and Systems Research (GHPHSR) research programme. Other collaborators of this project include Noguchi Memorial Institute for Medical Research (NMIMR); University of Ghana Legon; Amsterdam Institute for Global Health and Development (AIGHD), Netherlands; University of Amsterdam (UvA); Vrije University (VU), Amsterdam, Netherlands, University of Groningen, Netherlands; National Health Insurance Authority (NHIA), Ghana; Ministry of Health (MoH)/Ghana Health Service (GHS); Christian Health Association of Ghana (CHAG).