Service Quality Gaps in HIV Treatment at University of Port Harcourt, Teaching Hospital, Port Harcourt, Nigeria

Abstract

Background: Human immunodeficiency virus infection (HIV/AIDS) is a disease whose management has been fraught with challenges of service quality and poor treatment outcomes. This study assessed service quality (SQ) as a function of patients' expectations and perceptions of care.

Methods: A mixed-methods approach comprising a cross-sectional study of 343 clients selected using multi-stage sampling and transcendental phenomenology design using in-depth interviews of 10 clients selected through maximum variation sampling techniques. ServQual tool and topic guide were data collection instruments used for quantitative and qualitative data respectively. Quantitative data were analyzed with SPSS version 23 and qualitative by manual thematic content analysis.

Results: Respondents' mean age was 39.6± 11.3 years. The total mean expectation and perception scores were 4.61±0.57 and 4.35±0.58 respectively. Negative gaps were recorded in all the domains and the overall SQ gap (SQG) was -0.26;p<0.05. The widest gap was in the "tangible" domain (-0.94; p<0.05). There was a significant association between clients' educational status and SQG. The reasons for the gaps were poor toilet hygiene, overcrowding, short consultation time, and rudeness of some staff. domains. These findings are similar to studies done in Nigeria,1,2,3, and Middle East.4,5 It is however in conflict with a study in Thailand which found that patients' satisfaction was significantly higher than the mean patient's expectation in all dimensions.6 There is, therefore, a need for a conscious effort on quality improvement to meet patients' expectation

Conclusion: There were significant gaps between HIV patients' expectations and perceptions of SQ. As this could affect service utilization and treatment outcome, efforts should be made to address these gaps especially the poor toilet hygiene, and overcrowded consulting rooms.

Disclosure: The authors declare that there is no conflict of interest