Access, perceived quality and uptake of antenatal services in urban communities of Osun state, Southwest Nigeria

Quality antenatal care (ANC) is one of the key interventions to improve intrapartum care uptakes and to reduce the menace of maternal deaths globally. Yet, ANC coverage has remained low in many developing countries like Nigeria. It becomes imperative to contextually understand factors associated with ANC uptake in Nigeria. The study assessed level of utilization, perceived quality, level of satisfaction and determinants of ANC utilization among women of reproductive age-group in Oshogbo, South-west Nigeria. Cross-sectional study design was employed and cluster sampling method was used to recruit 420 consenting respondents. Data were collected using pretested interviewer-administered, semi-structured questionnaire. Both descriptive and inferential statistics were done at p<0.05. The mean (±SD) age of the respondents was 30.84±6.0 years. Almost three-quarters (73.9%) of the respondents had at least 4 ANC visits. Main reasons for non-ANC usage were high cost of care, long waiting time at the clinic, long distance to the clinic and unsatisfactory service quality. Only 59.9% of respondents were satisfied with services received while 63.1% of them rated the service quality as excellent. Main determinants of ANC uptake were respondents' age (AOR=2.35;95%CI=1.34-5.89), level of education (AOR=0.56;95% CI= 0.42-0.71), socio-economic status (AOR=5.22; 95%CI=2.02-6.65) and monthly family income (AOR=0.89; 95%CI=0.02-0.90). Although the rate of ANC use was high in the study setting, the proportion of women who were satisfied with service quality was sub-optimal. There is need for implementation of multi-pronged intervention to make ANC services more available, accessible, affordable and acceptable to the Nigerian women

Awareness and satisfaction with antenatal care services among pregnant women in Lagos state, Nigeria

Objectives: Despite the growing interest and efforts by government to make popular use of antenatal care (ANC) services in Nigeria as recommended by the World Health Organization, high level of infant and maternal mortality remains a major public health challenge facing the country. Dissatisfaction toward ANC services among pregnant women may be attributed to low level of awareness. This study assessed the level of awareness and satisfaction of ANC services among pregnant women in Lagos state, Nigeria. Material and Methods: The study adopted a survey research design. A multistage sampling technique was utilized to recruit participants for this study. A validated questionnaire was used for data collection and data were analyzed using both descriptive and inferential statistics. Ethical approval was obtained from Babcock University Health Research Ethics Committee with approval no: BUHREC543/17. Approval was also obtained from health service commission and in the six general hospitals used for the study. Informed consent was taken and respondents were reassured of the privacy and confidentiality of the information obtained. Results: The results showed that most of the respondents (85.6%) were in their reproductive years, that is, ages 23­37. The results showed that the level of awareness had a significant influence on pregnant women's satisfaction with the services (ß = 0.460, F(1,1313) = 351.499, R2 = 0.211, P < 0.05). The level of awareness of ANC services was high (M = 4.31, SD = 1.01) on a scale of 5. Conclusion: The study concluded that awareness of ANC services positively impacts pregnant women's satisfaction with the services in Lagos state. Efforts should be made to improve the level of awareness of pregnant mothers to achieve greater satisfaction with ANC services in Lagos state.

Optimising the learning environment for undergraduate students in the department of family medicine at sefako makgatho health sciences university

Background: An important determinant of a medical student's behaviour and performance is the department's teaching and learning environment. Evaluation of such an environment can explore methods to improve educational curricula and optimise the academic learning environment.Aim: The aim is to evaluate the educational environment of undergraduate students in the Department of Family Medicine as perceived by students.Setting: This descriptive quantitative study was conducted with one group of final-year students (n = 41) enrolled in 2018, with a response rate of 93% (n = 39). Students were in different training sites at SMU.Methods: Data were collected using the Dundee Ready Educational Environmental Measure (DREEM) questionnaire. Total and mean scores for all questions were calculated.Results: The learning environment was given a mean score of 142/200 by the students. Individual subscales show that 'academic self-perception' was rated the highest (25/32), while 'social self-perception' had the lowest score (13/24). Positive perception aspects of the academic climate included: student competence and confidence; student participation in class; constructive criticism provided; empathy in medical profession; and friendships created. Areas for improvement included: provision of good support systems for students; social life improvement; course coordinators being less authoritarian and more approachable; student-centred curriculum with less emphasis on factual learning and factual recall.Conclusion: Students' perceptions of their learning environment were more positive than negative. The areas of improvement will be used to draw lessons to optimise the curriculum and learning environment, improve administrative processes and develop student support mechanisms in order to improve students' academic experience

Satisfaction des parents accompagnateurs des enfants de moins de 5 ans pris en charge au centre médical de Kokologho au Burkina Faso

La satisfaction des usagers des centres médicaux (CM) au Burkina Faso n'est pas connue. Notre objectif était d´étudier le niveau de satisfaction et les facteurs associés des parents accompagnateurs des enfants de moins de 5 ans pris en charge au CM de Kokologho en 2018. Il s'est agi d'une étude transversale. Réalisée dans l'aire de santé du CM de Kokologho, les cibles étaient les parents accompagnateurs d'enfants de moins de 5 ans pour l´enquête ménage et pour les entretiens qualitatifs les représentants de la communauté, les agents de santé et les leaders administratifs et coutumiers. Les outils de collecte des données ont été construits à partir des référentiels (SAPHORA-job 2014, conseil Québécois d'Agrément 2005). Des scores de satisfaction, Odds Ratio ajustées et IC95 % ont été calculés. Des analyses thématiques ont été effectuées. Le niveau de satisfaction globale des parents accompagnateurs des enfants pris en charge au CM de Kokologho en 2018 était satisfaisant (70,6 %). Les dimensions étudiées étaient l'accueil (47,2 %), le respect (65,3 %), l'empathie (60,5 %), la confidentialité (73,8 %), la fiabilité (71,9 %), la rapidité (51,4 %), le confort (89,0 %), l'accessibilité géographique (97,5 %) et l'accessibilité financière (28,5 %). Le niveau d'instruction non scolarisé, le sexe féminin et la situation matrimoniale mariée étaient significativement associés à la satisfaction globale des parents. Les usagers sont satisfaits des services du CM de Kokologho. Cependant, des efforts doivent être faits pour améliorer l'accueil, la rapidité de l'offre de service et l'accessibilité financière

Patients' knowledge of health rights and satisfaction with outpatient services at the tertiary hospitals in Enugu state, Nigeria

BACKGROUND: Patient satisfaction is a key indicator for measuring the success of the health system goals, delivery quality care that is safe, equitable, patient-centered, evidence-based, timely and efficient, through interprofessional collaborative team work. Equally, patient's knowledge of their health rights will enhance better provider-patient's relationship, patient satisfaction, and effective care management. OBJECTIVES: The aim of this study was to compare patients' knowledge of health rights, satisfaction with the physicians' conducts and outpatient services across three tertiary hospitals in Enugu, Nigeria. METHODS: A descriptive cross-sectional study of 304 patients selected from the outpatient clinics of the University of Nigeria Teaching hospital (UNTH), National Orthopaedic Hospital (NOHE), and Enugu State University of Science and Technology Teaching Hospital (ESUTH), from October to December, 2015 was conducted. A four point Likert scale, dissatisfied (1), very dissatisfied (2), moderately satisfied (3), and very satisfied (4) was applied. Knowledge of health rights were scored as follows, 0-5 poor knowledge, 6-10 good knowledge, 11 and above very good knowledge. A minimum sample size of 91 patients was calculated for each of the study hospital, but increased to100 each, to enhance precision, reduce error margin, and to contend possible nonresponses and incompleteness. A multi-stage sampling technique was applied. The data were analyzed using SPSS version 16.0.RESULTS: Knowledge of health rights was poor in 5.9%, 20.8%, and 14.9% of patients (X2 =9.61, p=0.000), and very good in 70.6%, 2 46.5% and 59.4% patients (X2 =12.14, p=0.000) from UNTH, NOHE, and ESUTH respectively. The mean knowledge scores were 10.50 ±3.240 for UNTH; 8.72±2.953 for NOHE; and 9.93±3.151 for the ESUTH. The overall mean knowledge scores of the patients across the three hospitals was not statistically significant (F=0.000, P =1.000). Patients' overall mean satisfaction with physicians' conduct and services was 3.63±0.525 for UNTH, 3.45±0.741 for NOHE, and 3.47±0.609 for ESUTH, with no statistically significant difference (F=0.000, P =1.000). Overall mean satisfaction scores for the general outpatient services were 3.19±0.728, 3.15±0.713, and 3.00±0.721 for UNTH, NOHE, and ESUT respectively. The observed differences in the overall mean satisfaction for the general services provisions across the hospitals was not statistically significant (F=0.000, P=1.000). Patients' mean knowledge scores were statistically (p=0.000) associated with mean satisfaction with the physicians' conduct and services provision across hospitals. CONCLUSION: Patients knowledge of health rights and satisfaction with physicians' conducts and outpatient services across the hospitals were generally good and satisfactory, but differed statistically in-between hospitals

Perception and Satisfaction with Quality of Antenatal Care Services among Pregnant Women at the University College Hospital; Ibadan; Nigeria

Background: Antenatal care is an important health service which detects and sometimes reduces the risk of complications among pregnant women. The quality of care is likely to influence effective utilization and compliance with interventions. Objectives: This study evaluated clients' perception of antenatal care quality at the University College Hospital (UCH); Ibadan and determined levels of client satisfaction. Methods: Women presenting for antenatal care at the study centre were interviewed in a cross-sectional design using a structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables; assessment of quality of amenities; waiting time and level of satisfaction. Data analysis was done using frequency tables; Chi-square cross tabulations and logistic regression. The p-value was set at P0.05. Results: There were 239 participants; 74 percent of the women were aged 25-34 years; majority of the respondents (86) had tertiary education while 49.4 were skilled workers or professionals. In 57.7 of women; the gestational age was between 13 and 27 weeks while 66.1 were Para 1-4. Amenities and water supply were regarded as unsatisfactory in 60.7 and 61.9 respectively. The clinic services were regarded as good in 81.1 of respondents; the only significant association with patient satisfaction was the desire to register in the same facility in the next pregnancy. Conclusion: There is a high overall level of satisfaction with antenatal services among pregnant women in UCH. Policy makers and health providers should however address improvement of amenities; reduction of waiting time and ensure that health interventions are available for all clients

ART Patients' Satisfaction Level Regarding Comprehensive HIV and AIDS Care Management and Antiretroviral Treatment Programme in Pretoria

The purpose of this cross- sectional study was to investigate patients' satisfaction levels regarding access to; and quality of; comprehensive human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) care management and antiretroviral treatment programme (CCMT). A total of 402 patients were selected from three hospitals by stratified random sampling techniques. A self-administered questionnaire was used to assess patients' satisfaction levels. Almost all the patients ( 93) gave positive response towards access to CCMT services; and mentioned that the doctor was kind; polite; and showed them respect; the nurse was kind; polite; and showed them respect; doctors provided full attention during consultations; and they felt comfortable talking to the healthcare provider about their problems. More than a tenth (12) of the patients were dissatisfied with regard to privacy during consultation; and another 13 regarded the receptionist or booking clerk as unkind; impolite; disrespectful and unhelpful towards them. The majority ( 90) of the patients were very satisfied; or satisfied; with obtaining medication; with the explanation on how to take it; and with the counselling and privacy. Patients were mostly dissatisfied with HIV-specific material (19); assessment of financial status (19); and explanation of laboratory results (8). Access to; and quality of; the CCMT programme in the three hospitals in the Tshwane District is excellent; and in line with what has been prescribed in the operational plan. The availability of HIV-specific material has to be strengthened in order to help educate patients; so that they can better access healthcare facilities; and especially patients on the CCMT programme

Pregnant Women's Satisfaction and Comprehension Level of Information Given during HIV Counseling and Testing for PMTCT in Public Health Facilities in Addis Ababa

Background: In Ethiopia PMTCT services began in 2003; but only 0.8of HIV infections among births to HIV positive mothers were averted in 2005/6 through PMTCT. Objective: To determine the pregnant women's satisfaction and comprehension level of the information given during pre- and post- HIV counselling and testing for PMTCT in public health centers in Addis Ababa City. Method: A cross-sectional study was conducted on purposively selected 10 health centers in Addis Ababa from April to May 2008. Data were collected at exit points using a pre-tested structured questionnaire adapted from UNAIDS tools. Descriptive and analytic statistics were computed. Result: Of the 422 women interviewed; 314 (74.6) had discussion on MTCT/PMTCT; and 287 (91.4) of those 314 reported to have comprehended the information. Of the 196 third trimester mothers; 83 (42.3) were counselled on infant feeding options; among whom 59 (71.1) reported to have comprehended the explanations well. Two hundred eighty-eight (68.4) of the 422 clients had held discussions on HIV/AIDS; and 261 (90.6) reported that they had understood the discussions well. The odds of knowing why HCT is offered during pregnancy was higher among clients who spent 5-15 minutes on discussion with their counsellors [OR=2.1; 95CI: 1.03; 4.24]. Conclusion: About 3/4th of the ANC clients were covered with PMTCT counseling in the ANC and the vast majority of the women interviewed reported that they were satisfied with the counselling and counsellors' interactions with them. However; when prompted at the exit points; 21of the mothers didn't know why they were offered HCT particularly during pregnancy

HIV Counselling and Testing Utilisation and Attitudes of Male Inmates in a South African Prison

The Department of Correctional Services Policy on the management of HIV and AIDS for offenders include voluntary counselling and testing (VCT) for HIV as one of the priorities in the rehabilitation of inmates. The aim of this study was to determine factors associated with the utilisation of VCT services in the correctional centres in terms of level of satisfaction; their experiences and expectations; and motivating factors and barriers for VCT utilisation at Losperfontein Correctional Centre; South Africa. This was a case control study (cases being those who underwent testing and controls those who did not) examining predictors of HIV VCT utilisation among 200male adult sentenced inmates serving medium and maximum sentences. Results indicate that a poor health system (OR=0.34; 95CI:0.23 - 0.50) was inversely associated with HIV testing acceptance in prison; while age; educational level; population group; marital status; length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of the participants (50) agreed that VCT services are accessible and are promoted at their correctional centre. Most were satisfied with different components of VCT services; ranging from 79 (fair to very good) for 'the way he/she received you' to 62 'clarified all your concerns'. This study demonstrated some challenges and benefits to the field of health promotion and HIV prevention in the correctionalcentres especially with regard to VCT services

Coping Responses as Predictors of Satisfaction with Life amongst a Group of Patients Diagnosed with Diabetes Mellitus

The purpose of this study was to investigate the extent to which coping responses could predict the level of life satisfaction experienced by patients suffering from diabetes mellitus. A non-experimental; cross-sectional design was adopted. The sample consisted of 154 individuals (62 Type I diabetics; 80 Type II diabetics; and 12 individuals for whom diagnostic information was not available) recruited from the outpatient diabetes clinic at a large state hospital. All participants completed the Coping Responses Inventory - Adult Version; as well as the Satisfaction with Life Scale. Initially; Pearson product-moment correlation coefficients were calculated to examine the relationship between the predictor variables (coping responses) and the criterion variable (satisfaction with life). Hierarchical regression analyses were conducted to determine the amount of variance in the satisfaction with life scores that was explained by coping responses. The combination of approach and avoidance coping subscales accounted for 33of the variance in the participants' satisfaction with life scores. However; upon further analysis; the avoidance coping subscales were found to account for 28of the variance in the sample's satisfaction with life. The cognitive avoidance subscale and the acceptance or resignation subscale were found to correlate negatively with satisfaction with life at the 1level of significance. It appears that approach coping responses do not predict the satisfaction with life experienced by individuals suffering from diabetes. However; avoidant coping responses; particularly cognitive avoidance and acceptance or resignation; are predictive of lower levels of satisfaction with life

Patient Satisfaction with Quality of Primary Health Care in Benghazi; Libya

Introduction: The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance; but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS efforts. Objectives: To assess patient satisfaction with quality of PHC assessed in terms of (a) customer profile; (b) patient satisfaction; and (c) health care-seeking behavior. Methodology: A sample of nine health centers and seven polyclinics from various locations in Benghazi; Libya were selected for gathering information by structured face-to-face interviews. A total of 310 beneficiaries were interviewed by using an Arabic translation of the Charleston Psychiatric Outpatient Satisfaction Scale. Results: The beneficiaries appear to be quite satisfied with the quality of services. Geographical zone; marital status of beneficiary; and type of facility are satisfaction-related factors. There are preferences for facilities located within the City Centre over those located elsewhere. There is also an interaction effect of the geographical zone and the type of facility in creating differences in satisfaction. Conclusions: A customer-friendly facility concept that emphasizes reception; physician interaction; and cordiality shall add value. Polyclinics require more attention as does the Al Slawy area. A few utility services might also be considered

An Assessment of Client Satisfaction with Services at a Model Primary Health Care Centre in Ogun State; Nigeria

BACKGROUND: Assessing patient satisfaction with health care is increasingly becoming an integral component of quality monitoring in health care systems. However; studies that have been conducted in this environment often show that clients' perceptions of quality of care from public sector providers are generally low. Timeliness; which refers to obtaining needed care and minimizing unnecessary delays in getting that care; may impact considerably on patients' satisfaction. This study w as designed toexamine how the consumers of services at a model primary health centre in Ogun State; Nigeria; viewed their health-seeking experience; relating this to the level of organization.and timeliness of health services provision. OBJECTIVES: This study sought to assess the satisfaction of clients with services at a model PHC centre at Pakoto; Ogun State; Nigeria. METHODS: The Pakoto model primary health care centre is an outstation of the Lagos University Teaching Hospital (LUTH) Idi-Araba; Lagos State. The study was carried out on weekday mornings at the model PHC clinic during the month of June; 2006. Methods of data collection employed were a general observation of clinic activities; and the administration of a modified client flow analysis chart to clients as they exited the health facility. RESULTS: The peak time of arrival of clients was between 9.00 and 11.00 a.m. when the majority (58.5) of clients arrived; the majority of clients (84) exited the facility oetween 11:00 a.m. and 1:00 p.m. The highest proportion of clients (33.1) spent 3-4 hours accessing services at the model PHC facility. Good staff attitude topped the list of aspects of service liked most by clients (36); while the aspect of service liked least by respondents was lack of timeliness of services (43). Suggestions for improvement of services included increase in the number of staff and staff training (30) and early arrival of staff to work (13). CONCLUSION: The study concludes that timeliness of services at the primary health care level impacts positively upon the perception of quality of services rendered to clients

Occupational Stress among Radiographers: Impact of Sonography Responsability

Role extension in any occupation can affect both psychosocial and biomechanical stress levels and thus; have some consequences on efficiency in service delivery. The study was aimed to determine the impact of role extension of medical radiographers into sonography. 50 self-administered questionnaires were distributed to radiographers and to sonographers (radiographers with sonography responsibility). The questionnaires included questions seeking information on the demographic profile of the radiographer and sonographer; anatomical regions of biomechanical symptoms/stress and visual analogue scale (VAS); which rated job satisfaction and anxiety levels. 96of the questionnaires were returned and analyzed statistically using SPSS 11.0 software with P 0.05 indicating level of significance. Sonographers had more prevalence of biomechanical stress symptoms than the radiographers. Job satisfaction for sonographers (58.75) was lower than that for radiographers (64.29). Anxiety level was higher among sonographers even though this was not statistically significant. Sonography responsibility on radiographers did not have any significant effect on psychosocial stress. A balance in the extended role could aid efficiency in service delivery while improving the social strength of the individual

Job satisfaction amongst Nigerian ophthalmologists: an exploratory study

Aim: This study aimed to assess job satisfaction amongst Nigerian Ophthalmologists. Methods: The study was conducted during the annual congress of the Ophthalmological Society of Nigeria in September 2008. One hundred and ten ophthalmologists were selected by simple random sampling and asked to complete a structured questionnaire. Results: The response rate was 73. The resulting sample comprised of 48 consultants (60); four diplomates (5); and 28 residents (35). Most respondents 62 (78.5) were satisfied with their job as ophthalmologists and 17 (21.5) were not satisfied. Only 12 (15.4) were satisfied with their remuneration and 42 (53.2) were satisfied with their skill. Most respondents (75.6) expressed readiness to pursue a career in ophthalmology if they were to make a choice again. Conclusion: Most respondents were satisfied with their job but only minorities were satisfied with their remuneration. Therefore; there is a need to address the issue of enhancement of remuneration for ophthalmologists in Nigeria

Client's Satisfaction with Services for Prevention of Mother-To-Child-Transmission of HIV in Dodoma Rural District

Objective: The study was conducted to assess clients' satisfaction with PMTCT services on privacy; waiting time and counselling in PMTCT of HIV /AIDS in Dodoma Rural district. Methods: A cross sectional study was conducted to 208 women assessing Reproductive Child Health (RCH) and PMTCT of HIV services. Data collection method involved both client exit interviews and focus group discussions (FGD) with women attending RCH services. Systematic random sampling technique was used to obtain the required sample of 208 clients for the exit interviews. A total of five FGDs were conducted each with eight to ten people. The data obtained were analysed using Epi Info. Settings: Dodoma Rural district; central Tanzania Results: Of 113 clients' who accessed PMTCT services; 75.2were satisfied with the counselling provided. A significant difference (P = 0.02) was observed between clients with no formal education as compared to those with primary level of education and above. Nearly a quarter of the clients who accessed PMTCT of HIV services were not satisfied with the privacy in the settings providing the service. It was also found that 71.7of clients accessing PMTCT of HIV service was satisfied with the waiting time spent for the service; however a difference was observed (P = 0.001) between clients who accessed services at health centre (77.6) and hospital (33.3). Conclusion: A quarter of the clients were not satisfied either with the counselling they received on PMTCT of HIV; privacy or waiting time they spent while accessing services. Some of the reasons contributing to dissatisfaction included inadequacy in individual counselling; inadequate on site test supplies and equip- ment and cost incurred when travelling to seek for PMTCT service from a referral or satellite health facility

Dental Care Utilization and Satisfaction of Residential University Students

Aim: The objective of this study was to provide information on the level of utilization and satisfaction of residential university students with the dental services provided by the dental clinic of a teaching hospital. Volunteers and Material: A stratified sampling technique was used to recruit volunteers from the outpatient clinic of the Obafemi Awolowo University Teaching Hospital Complex; Ile-Ife; Nigeria. Information was collected by a self-administered questionnaire composed of questions that measure the level of utilization and satisfaction with the dental services provided. Questionnaires were provided to 650 randomly chosen students residing in the University hostels. There were 39 refusals; and 6 incomplete questionnaires were discarded. This left a sample size of 605 volunteers. Results: Forty seven students (7.8) indicated that they visited the dental hospital within the last 12 months. Males and females utilized the dental services equally; and utilization increased with age and the number of years spent on campus. Anticipation of painful dental treatment; high dental charges; long waiting times and being too busy for a dental visit were cited as the most important impediments to seeking dental treatment. Females expressed greater satisfaction with the services. Conclusion: Dental service utilization among the students was found to be low. Oral health awareness campaigns; improving the quality of the services; and shortening the waiting time are expected to increase service utilization and satisfaction

Gender-Wise Comparison on Emotional Intelligence and Marital Satisfaction

The research aims at exploring and comparing the marital satisfaction and emotional intelligence of people between age 25-65. Tools used were namely Marital Satisfaction Scale (MSS) and Exploring Emotional Abilities (EEA). A fairly representative data of 316 respondents was collected from Maharashtra; India. The analysis indicates a significant gender difference on certain areas of emotional intelligence; namely; openness to criticism; self management and empathy. A significant gender difference is also noted on two areas of marital satisfaction; namely; sexual relations and sharing household responsibilities; which can be traced to the socio-cultural influences. This has helped in understanding the relationship of gender with core traits of one's emotionality; which influence the marital relationship

Evaluation de la satisfaction des patients ; quelle place dans la performance d'un hopital ? Exemple des consultations externes de PPH du CHU de Cocody

Durant la periode du 31juillet 2000 au 04 Octobre 2000; nous avons effectue une etude prospective portant sur l'etat de satisfaction de nos patients en consultation externe de PPH de Cocody.Cette etude avait pour objectif principal d'apprehender les differents niveaux d'insatisfaction et de satisfaction depuis le premier contact du patient avec l'hopital jusqu'a sa sortie de la salle du medecin. De facon specifique; nous nous sommes proposes d'apprehender les differents parametres d'insatisfaction et de satisfaction; de situer les differents niveaux de responsabilite et d'attirer l'attention des decideurs politiques et des prestataires de service sur la situation. Cette etude a sur 150 patients ayant comme caracteristiques sociodemographiques :-les hommes : 52;66 pour cent. -les femmes 47;33 pour cent. -une moyenne d'age de 29 ans. -les patients non scolarises 27;33 pour cent. -patients assures 2 1;33 pour cent. -patients payant en espece la consultation : 74 pour cent. Dans ses rapports avec les vigiles; en passant par le bureau des entrees jusqu'a la salle de consultation; le jugement du patient reste tres fortement tributaire de : -son age; -son sexe; -sont temps d'attente; -son mode de paiement; -l'information qu'il recoit sur sa maladie