Patients' Ratings of the Quality of their Outpatient Visit to Clinical Officers in Kenya

BACKGROUND: Lack of data on the quality of care offered by Clinical Officers (COs) compromises the current efforts on health reforms in Kenya. The objective of this study was to assess patients' satisfaction with their outpatient visit to Clinical Officers. METHODS: This was an exit survey of adult outpatients who visited Clinical Officers between September 2009 and May 2010. A total of 326 Clinical Officers were assessed by 2118 randomly selected patients across the country using a modified Visit-Specific Satisfaction Questionnaire (VSQ-9). Responses on patients' satisfaction were summarized using the average score method. This involved calculation of the mean across all the response categories and transforming them linearly to a 0 to 100 scale. Interpretation involved comparisons to best practice (excellent). RESULTS: Generally, patients view the quality of their outpatient visit from two dimensions: interaction with Clinical Officers and access to care. The patients were relatively more satisfied with their interaction with Clinical Officers (rated at 67 percent) than with access to care (61 percent). The average age of the patients was 31.31 years (SD = 13.64). Most patients were female (58 percent), married (51 percent) and most had secondary level education (38 percent). Regression results showed that these sociodemographic characteristics had no significant association with patients' satisfaction. CONCLUSION: Overall patients see ample room for improvement in their visits to Clinical Officers. The need to train Clinical Officers on client handling and patient-centeredness is apparent.