Health Services Quality and Public Satisfaction: Public Accountability of Basic Health Care System in Pakistan

Abstract

Good quality health care promotes well-being among individuals, societies and communities and expenditure on improving public health care services is a part of long term strategies of almost all governments around the world. Public satisfaction with any product or service is a major indicator of its effectiveness. This study highlights the efficiency of basic health care units through the subjective measure of public satisfaction, and the impact of behavioral variables on public satisfaction. These explanatory variables can be classified as employment status, wealth, demographic factors, social connectivity and access to basic health care units. The results show that 45 percent of therural households are dissatisfied; which is an indication that in rural areas these units are not working properly due to non-availability of staff and facilities. The results for educational status reveal that the likelihood of satisfaction for educated households is higher. However, the households who have television were 33% less satisfied than who do not have television, even though access to technology is linked to higher levels of satisfaction. The study results show a strong negative effect of distance from basic health care units on public satisfaction. Assessing the reasons for dissatisfaction, the survey data highlights that 38 percent of the households are dissatisfied because the health care center is too far, 33 percent mentioned insufficiency of health facilities in these centers and 12 percentstated shortage of staff as the reason for dissatisfaction. In Pakistan health spending is barely 1 percent of GDP and this glaring lack of facilities demands more investment in this sector.