Yesterday I had the privilege of attending a meeting with more than two dozen community leaders from the zones surrounding Hope Clinic Lukuli.
Hope Clinic was established in 2000 and some of the leaders attending had been accessing services for more than 10 years. The clinic is located right in the heart of the community, within a short walking distance for those that it serves; so it is ACCESSIBLE.
The clinic is able to provide some services free, depending upon Ministry of Health, Donor and Charity support. Other services are priced simply to cover costs; HCL is a not-for-profit organisation. Against many measures its services are AFFORDABLE.
Services provided include comprehensive maternal healthcare and HIV testing and treatment. Patients are attended to by trained clinical staff, supported by experienced laboratory technicians and a well stocked pharmacy. So, unlike many public centres, HCL is appropriately staffed and supplied. Required services are AVAILABLE.
I came to the meeting expecting some push-back about costs or about the lack of hospital services (HCL is essentially an outpatient clinic, with Midwife led in-patient services for normal deliveries.) I was therefore quite surprised when the overwhelming feedback was that local people preferred to go to the local drug shops and traditional birth attendants because these provided much better “customer care”.
It seems that Cost is not the most important factor for patients, but rather how friendly and caring the staff are. I’m ashamed that after 3 years here in Uganda I’m caught by surprise by this. I’m sorry if I thought that those with less income would be content with the quality of healthcare service being provided and the fact that it was accessible and affordable. This is is an eye-opener.
Professionals in the Healthcare sector often think little or even disparagingly of the TBAs and Drug Shops. We often say that they are not providing sufficient quality of care, they don’t practice evidence based medicine and perhaps even that they are not safe. What I now see is that the patients who seek care and treatment are better able to judge the quality of customer care and they value friendly, caring service perhaps more than the quality and safety of the clinical services provided. That I think is because they can judge when customer service is good, easier than judging when the clinical care is good.
Perhaps we need to design a Health System in which the professionals judge the patient safety and quality of care and the patients judge the customer satisfaction?