Quality of care has become a major concern worldwide, for both health-care institutions and policymakers, in a context marked by the continuous pursuit of efficiency, equity, and user satisfaction. Patient satisfaction is now recognized as a central indicator of the quality of services provided in health-care facilities, directly linked to lived experience, safety, and health system performance [1]. It is defined as patients’ subjective assessment of the quality of care received, based on their expectations, needs, and experiences within the health system [2].

The Richard-Toll public health establishment (EPS) plays an essential role in access to care in a highly rural area. It is the referral facility for the entire department of Dagana and part of neighbouring Mauritania; as such, it serves a large population and constitutes a key component of the health system in northern Senegal. Like many health facilities, it faces challenges related to the continuous improvement of care quality, patient satisfaction, and the efficient management of resources [3].

Regular assessment of patient satisfaction is therefore essential. It not only helps identify the strengths and weaknesses of the system but also guides reforms and health policy decisions [4]. Although efforts have been made to improve service delivery, users of the Richard-Toll public health facility still report recurrent complaints regarding reception, waiting times, attentiveness, and care [5]. It is therefore crucial to objectively measure patient satisfaction in order to identify shortcomings and propose concrete, context-appropriate improvements.

This study aimed to describe the level of satisfaction of patients hospitalized for at least 24 hours and of the persons accompanying them at the Richard-Toll Public Health Facility, across the dimensions of care assessed, and to formulate concrete recommendations to support the institution’s quality improvement approach. The study was purely descriptive: no analysis of the association between participants’ characteristics and their level of satisfaction was undertaken, and no determinant of satisfaction is claimed here. The analytical framework adopted was based on Donabedian’s model (structure-process-outcomes), adapted to the assessment of user satisfaction [6].

This study found a high overall level of satisfaction among users of the Richard-Toll EPS, with favourable ratings for reception, staff courtesy, cleanliness of the setting and the care received. The descriptive design does not allow any of these dimensions to be identified as a determinant of overall satisfaction.

The observed female predominance (68.6%) may be explained by women’s more frequent use of health services, particularly because of their role in reproduction and obstetric and gynecological follow-up, as well as in accompanying children [9]. This finding is consistent with results from the Saint-Louis Regional Hospital Center study, which also reported a female predominance of 65% [10]. The high representation of the adult age group reflects substantial service use by the working-age population. The geographic distribution confirms the facility’s strategic role in providing health coverage for the Senegal River basin, drawing patients from across the region and from neighbouring Mauritania, while distance and travel costs limit attendance from more remote localities [11]. The predominance of the tertiary sector—largely informal in this setting—together with the share of respondents working in agriculture reflects the socioeconomic profile of the area, where the population relies predominantly on the public health system.

The predominance of the emergency department as the main point of entry is consistent with the nature of this service, which is often perceived as the fastest route to care because it is accessible 24 hours a day and does not require a prior appointment [12]. The low educational level of a substantial proportion of patients may affect their understanding of hospital procedures and communication with staff [13]. The relatively short mean length of stay (2.8 days) and the limited variability in hospitalization duration may reflect the case-mix of a first-level referral hospital; early discharge, transfer to a higher-level facility or financial constraints cannot be ruled out as alternative explanations.

At the relational and organisational levels, the administrative procedures perceived as straightforward by the majority (79.3%) suggest a well-organised admission process. Waiting time was not measured in this survey, and its relationship with the perceived simplicity of formalities remains hypothetical. The minority who considered the procedures complicated nonetheless supports the need to simplify certain steps [14]. Most respondents described the paramedical staff as courteous (70.2%) rather than aggressive (3.3%), which is consistent with a positive caregiver–patient relationship; the cases of perceived aggressiveness, although rare, support the need to strengthen training in communication and empathy [15]. The near-systematic respect for privacy (>97%) reflects staff professionalism and constitutes a fundamental pillar of care quality and human dignity [16].

The broadly positive assessment of the care received (91.7% favourable opinions) and of cleanliness (90.1% for the rooms, 92.5% for the sanitary facilities) reflects the institution’s efforts to improve the material conditions of admission and hospital stay, cleanliness and material conditions being recognized determinants of user satisfaction [17]. However, the more moderately rated comfort of the furnishings and the predominantly shared nature of hospitalization, which limits privacy and individual comfort, remain areas requiring attention [17].

The use of convenience sampling may introduce selection bias. Patients’ responses may also be influenced by social desirability, all the more so as the questionnaire was administered face-to-face by interviewers within the facility itself. Three further limitations should be acknowledged. First, the questionnaire was purpose-built and has not undergone formal psychometric validation in this setting; its internal consistency and construct validity were not assessed, which limits comparability with studies using validated instruments such as the PSQ-18 [18] or the Picker Patient Experience Questionnaire [19]. Second, a majority of respondents (53.7%) were accompanying persons answering as proxies, and proxy assessments are known to differ from patients’ own assessments [20]; the direction of this bias could not be examined here. Third, the design was purely descriptive: the study describes the level of satisfaction but does not establish any determinant of it, and the interpretations proposed in the Discussion are hypotheses to be tested in a subsequent analytical study.

Richard-Toll Public Health Facility shows a high overall level of satisfaction, with favourable ratings for reception, staff courtesy, cleanliness of the environment and the care received (91.7% favourable opinions). These findings reflect the efforts made by management and staff to improve conditions of care. Nevertheless, the results point to two priority areas for improvement: the comfort of the furnishings, rated satisfactory by only 57.0% of respondents, and the predominantly shared nature of hospitalization, 86.0% of respondents having no individual room, which limits privacy and individual comfort during the stay. As user satisfaction is a dynamic concept, periodic evaluation and the integration of the patient’s voice into hospital governance would constitute a major step toward genuinely patient-centred care.

The authors thank the management team and staff of Richard-Toll Public Health Facility, as well as all the patients who agreed to participate in this study.

AsségaSylvain Sagna: conception and design; questionnaire; statistical analysis; drafting of the manuscript.

Hubert Feuhy Coly: data collection; final approval.

Mohamed Lamine Diao: critical revision; final approval.

AsségaSylvain Sagna is the Author who has checked every reference and confirmed the authenticity of every reference.

This study received no specific funding.