TITLE:
Patient-Provider Interaction in Primary Healthcare Facilities in Tanzania: Findings from Star Rating Assessment
AUTHORS:
Erick Kinyenje, Mbwana M. Degeh, Omary A. Nassoro, Radenta P. Bahegw, Joseph C. Hokororo, Talhiya A. Yahya, Chrisogone J. German, Mohamed A. Mohamed, Ruth R. Ngowi, Yohanes S. Msigwa, Laura E. Marandu, Syabo M. Mwaisengela, Upendo Kimaro, Janeth S. Masuma, Faraja Msemwa, Michael Habtu, Grace Saguti, Eliudi S. Eliakimu
KEYWORDS:
Patient-Provider Interaction, Primary Health Care, Star Rating Assessment, Tanzania
JOURNAL NAME:
Journal of Service Science and Management,
Vol.16 No.5,
October
26,
2023
ABSTRACT: Background: Effective patient-provider interaction plays a critical role in ensuring high-quality
healthcare. Tanzania implemented the Star Rating Assessment (SRA) program since
2015/2016 to evaluate
service delivery quality in primary healthcare (PHC). The SRA evaluates various
aspects, including patient-provider interaction. This study analyzes data from the
latest nationwide assessment conducted in 2017/2018 to provide
insights into the status of Tanzanian facilities in this area and identify potential
influencing factors. Methods: The quality of patient-provider interaction
was assessed using five indicators: provider’s friendliness, thorough history-taking, complete examination,
effective communication of diagnosis and treatment, and sufficient time spent with
the patient. Facilities scoring at least four indicators (80%) were deemed
to have good interaction. Proportions of facilities with good interaction overall
and for each indicator were determined. Multiple logistic regression analysis was
performed to investigate the associations between good interaction
and different characteristics of PHC facilities, including location (rural or urban),
facility level (dispensary, health center, or hospital), ownership (public or private),
gender of the facility’s in-charge, and type of provider (nurse, clinician, or other
non-clinical staff). Associations were considered statistically significant if the p-value was less than 0.05. Results: In our study, we included 6663 primary healthcare (PHC) facilities, of which
50.3% (3350) exhibited good interaction. The lowest scores were recorded for complete
patient examination (50.4%) and thorough history taking (51.5%). The findings suggested
that privately owned facilities, urban facilities, and facilities overseen by male
facility in-charges were associated with good interaction. Provider type, consultation
room facilities, and tracer medicines availability showed no significant associations
with the quality of interaction. Conclusion: The quality level of patient-provider
interaction in PHC facilities in Tanzania is still unsatisfactory. Improvements
in infrastructure should go hand in hand with strengthening service delivery management,
especially in rural areas and public PHC facilities.