Patient Satisfaction at the Muhimbili National Hospital in Dar Es Salaam; Tanzania

Objectives: Patients are the primary beneficiaries of the services and care that hospitals provide. The Patient Satisfaction study examined the extent to which patients at the Muhimbili National Hospital (MNH) were satisfied with the services and care they received at MNH. This was part of a baseline study that sought to determine the level of performance of the hospital before massive restructuring; reform; and renovations were undertaken. Methodology: Exit interviews were the main research method used to determine patient satisfaction. Patients were interviewed as they were leaving the OPD clinics; laboratory; X-ray; pharmacy and inpatient wards. Results: The study found that most patients were satisfied with the services and care they received. This high level of satisfaction must be viewed within the context of a hierarchical public health care delivery system; with MNH at the apex. The services and care MNH provides can only be excellent compared to that provided by lower level health facilities. Indeed; patients covered by this study perceived the services provided by MNH as superior; and this was reflected in the high level of satisfaction they reported. Some patients expressed dissatisfaction with specific aspects of the services that they received. They were particularly dissatisfied with long waiting times before receiving services; the high costs of treatment and investigations charged at MNH; poor levels of hygiene in the wards; and negative attitudes of staff towards patients. Conclusion: Although only a small proportion of patients expressed dissatisfaction with these aspects of the services provided; they are significant in that they constitute a call for action by the MNH management to encourage the health personnel to embrace a new staffpatient relationship ethos; in which the patient is a viewed as a customer

Management and Organization Reforms at the Muhimbili National Hospital: Challenges and Prospects

Objective: To establish the state of organization structures and management situation existing at the Muhimbili National Hospital (MNH) and Muhimbili University College of Health Sciences (MUCHS) prior to the start of the MNH reforms and physical infrastructure rehabilitations. Methods: A checklist of key information items was used to get facts and figures about the organization of the MNH and management situation. Interviews with MNH and MUCHS leaders; and documentation of existing hospital data were done to gather the necessary information. Results: The survey reveals that there are a number of organizational; managerial and human resource deficiencies that are impinging on the smooth running of the hospital as a national referral entity. The survey also revealed a complex relationship existing between the hospital and the college (MUCHS) that has a bearing on the functioning of both entities. Conclusion: In order for the hospital to function effectively as a referral hospital with a training component inbuilt; four basic things need to be put in place among others: a sound organization structure; adequate staffing levels especially of specialist cadre; a functional information system especially for inpatient services and a good working relationship with the college