Interrogating decentralised healthcare service delivery quality in Lesotho through the patient’s eyes

Abstract

As African countries continue to improve their healthcare quality, a study of this nature that sought to examine satisfaction with healthcare services from the perspective of healthcare users cannot be overemphasized, as the findings serve as a benchmark to guide policy decisions in the healthcare sector. This study assessed perception of satisfaction on the quality of decentralised healthcare service delivery from a positivist research orientation. A total of 408 users of healthcare services from 10 districts of Lesotho were selected to respond to a set of questionnaires and a researcher-administered survey developed from the six World Health Organisation–defined dimensions of quality healthcare: safety, equity, acceptability, accessibility, efficiency, and effectiveness. Descriptive and inferential statistics were used for analysing the data obtained. The findings of the study revealed mixed feelings among users of healthcare services in Lesotho. For example, healthcare users were generally satisfied with how receptive service providers were to innovative service delivery, honesty, and the overall competence of healthcare service providers. However, significant deficits were observed in treatment safety, record-keeping, equitable geographic service distribution, and timely access. Particularly worrying were concerns about drug administration, rural service equity, and duplication of health procedures. There were no significant differences in the respondents’ satisfaction regarding healthcare services despite variations in their sexual orientation and age distribution. The study highlights the systemic inequalities and inefficiencies that counter the desired objectives of decentralised healthcare and the critical need for participatory health governance, digital health systems, improved communication strategies, health infrastructure investments and adaptive governance frameworks to bridge the disconnect between the lived experiences of healthcare users and decentralised health policy frameworks. The results offer evidence-based insights for healthcare administrators, donors, health communicators and policymakers seeking to enhance equity and quality in healthcare in resource-constrained African settings.

Keywords: {'name': 'health care quality'}, {'name': 'public health policy'}, {'name': 'health care service delivery'}, {'name': 'patient satisfaction'}, {'name': 'decentralised health care in Lesotho'}

Authors & affiliations

Christopher Dick-Sagoe
University of Botswana; University of South Africa

Daniel Odoom
Institute of Journalism, University of Media, Arts and Communication, Ghana

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