Patients' perception of service quality in a healthcare not-for-profit organisation

Service organisations should be aware of those elements that are perceived as excellent quality and incorporate these as part of their service offering. However, a not-for-profit (NPO) healthcare organisation consists of a diverse group of stakeholders who have different perspectives and interests. Service quality therefore requires a multidimensional definition that comprehends all their needs and expectations.Methods: Perceived service quality experienced by patients was measured by completion of the Service Performance (SERVPERF) questionnaire. A total of 111 patients completed the questionnaire across three mobile clinics supported by an NPO.Results: The research results suggested that service quality at the mobile clinics was of a very high standard, with no meaningful differences between clinics, age groups or gender. However, the responses had very little variance and could have been subjected to response bias or extreme bias. The absence of a comparator organisation could also have had an influence on responses given by respondents. Conclusion: Healthcare service organisations should strive towards maintaining high standards and engage in continuous measurement and improvement of their service quality as part of their quality management process. By measuring the current level of service experienced by patients, insights have been identified where adjustments might have a positive effect on perceived value. Future research recommendations include suggestions to increase the sample population, taking the service setting into account and further studies to confirm the validity and reliability of solicited service quality questionnaires in a NPO setting.

Value and Importance of Informed Consent to Researchers at Makerere University

Background: Respect for persons requires that research participants be given the opportunity to make choices about what should be done to them. Many times; the process of informed consent is abused to the benefit of researchers while exploitation and harm to the research participants may occur. In Uganda; issues of questionable research ethics have been highlighted in the past. Objective: To determine the Value and importance of the informed consent process among researchers at Makerere University. Materials and Methods: This was a qualitative descriptive study design involving faculty and graduate students in the faculties of Medicine and Social Sciences. Results: Of the 37 respondents 68were faculty while 32were graduate students in the fields of social sciences; clinical and basic sciences. Mean research experience was 8.5 years. More than 70of the respondents have had no formal training in research ethics. Only 22of the respondents appreciated the need for research participants to comprehend the informed consent; 38thought it is not always the case and in many cases their subjects do not have to comprehend; while the remaining 40believe that research subjects' understanding of the informed consent process may not be necessary. All respondents appreciated the importance of confidentiality although data management procedures were lacking by many. Conclusion: Most researchers appreciate the importance of confidentiality; but have limited understanding of the process of informed consent; information handling and the importance of feedback

Experiences of sexual relationships of young black women in an atmosphere of coercion

Negotiations surrounding sexual activity are characterised by multiple power disparities that include race; social status and age; with gender being the most dominant differential in heterosexual interactions. Research has shown that women are physiologically more at risk of contracting HIV than men; as indicated by the higher infection rates of the former. Many African societies operate via a hegemonic masculinity; with patriarchal governance and female subordination being the norm; placing women at even greater risk of HIV infection. In this qualitative phenomenological study; four black school-going adolescent women living in Grahamstown were interviewed using a semi-structured interview to gather data. An interpretative phenomenological analysis was conducted on the data to provide subjective insights of the experiences of the participants with regard to their interactions with men. From the findings; it became apparent that the participants felt pressured; coerced or manipulated by male counterparts. This pressure and coercion was not just felt in their interactions with older men; but also in their romantic partnerships. Three of the participants experienced pressure to engage in sexual intercourse with their boyfriends when they were unwilling or unready; and they reported being faced with additional pressure to engage in unprotected sex. Furthermore; it became apparent that each participant had an underlying fear of being raped and considered this as a genuine threat to her safety and sexual health. The atmosphere within which these participants negotiate their sexual agency is thus heavily informed by male control; coercion and the threat of violence or rape

The Use of Culturally Themed HIV Messages and their Implications

The 'ABC' approach promoted at the beginning of the HIV/AIDS epidemic in Botswana has failed to yield significant behaviour change. Formative research was conducted in urban; semi-urban and rural areas to explore how the use of sociocultural messages depicted in posters elicited people's response to HIV/AIDS-related behaviours. The research interrogated values and practices underpinning Tswana philosophy in relation to parentchild communication; voluntary counselling and testing; condom use and faithfulness. A total of 206 individuals aged 15-49 years were purposively interviewed.The results showed that this campaign was perceived as an activation of positive Batswana culture to modify harmful norms; values and social practices; drawing upon those cultural aspects favouring more positive behaviour.We conclude that behaviour change communication should promote links to cultural values and principles.This can be achieved by: communication in other languages in order to reach all groups in Botswana; providing opportunities for venturing into other ways of communicating HIV/AIDS messages to Batswana in light of literacy skills; and using communication media that is developed on the basis of cultural approaches and focuses on segmented population groups

The South African Traditional Belief Scale as an Instrument to Aid Culture-Congruent Health Care

Medical and psychological health care professionals are becoming increasingly aware that effective treatment in culturally diverse societies requires sensitivity to the patient's cultural beliefs and customs (Davidhizar et Giger; 2001:2; Foley et Wurmser; 2004:2; Hickson et Christie; 1989:162; Mkize; 2003:4; Narayanasamy; 2003:1). To this end this article introduces the South African Traditional Belief Scale (SATBS) as an instrument to enable culture-congruent care; not only in the medical field; but also in psychotherapy and counselling. This scale measures the extent to which black South Africans adhere to traditional beliefs and customs. To obtain reliability and validity data; 64 second-year students were randomly selected at the East Rand campus of Vista University. The reliability of the SATBS was established by calculating inter-item correlations. A reliability coefficient; or index of internal consistency of 0.91 (Cronbach alpha) was obtained after the first iteration. In order to establish criterion validity; the South African Traditional Belief Scale was validated against the Degree of Enculturation Survey (DES) by using the same random sample. A validity coefficient of 0.7899 was obtained which indicates a high index of criterion validity. The questionnaire therefore measures what it purports to assess

Gender related factors that put women at risk of HIV infection in Uganda

Gender roles and relations in the Uganda society have made women especially between the age group of 15 and 30 years; more susceptible to HIV infection; as compared to their male counterparts in the same age group. Project: Through counselling of young women in hospital outpatient clinics; hospital wards; prisons; teenager centres and also training of different women leaders in different communities in Uganda; it was observed that the socialisation process and stereotypying of roles of both men and women right from childhood; exposes the women more to HIV infection as compared to their male counterparts. Results: The following gender related factors that put women at risk of HIV infection were highlighted: 1. Decision making power 2. Reproductive role 3. Biological susceptibility 4. Choice of contraception 5. Accessibility of appropriate health services 6. Age 7. Accessibility to information 8. Literacy levels 9. Economic alternatives 10. Mobility patterns 11. Cultural factors 12. Attitudes towards relationships. Lessons Learned: The socialisation process of both men and women; right from child-hood; as well as the stereotyping of their roles in society; has exposed young women more to HIV infection as compared to their male counterparts. Intervention measures to facilitate HIV prevention should therefore be gender sensitive and community based in their approach considering different population groups in their specificity; within their social and cultural framework. Source: Int-Conf-AIDS 1996 Jul 7-12; 11(2): 458 abstract no. Pub.C. 1128)