The study reported on is part of an effort to improve
the quality of care provided by the Botswana Ministry of
Health (MOH). The study objectives were to: identify
priority areas for improvement at the Scottish
liVingstone Hospital (SLH) by assessing inpatient,
outpatient, and community client satisfaction; to
develop practical tools to measure client satisfaction
throughout services rendered by the Botswana MOH.
The study was carried out during August 1998 to March
1999 by the MOH Health Research Unit in three phases
namely: (1) qualitative research project involving
community leaders and hospital patients; (2) exit
interviews with 341 patients; and (3) participatory
qualitative research project on the dissemination of
research results involving hospital staff so they could
share and prioritise best and worst aspects of care, as
well as the causes and solutions involved. Triangulation
of research methods is thus indicated.
The study found a wide range of deep concerns among
participants relating to reception, waiting times,
privacy, health worker attitudes, health care, health
education, staffing and supervision. SLH health care
providers validated findings on problems and their
perceived causes.
The internal consistency among phases increased
confidence in the findings. The participatory approach
with SLH staff garnered support to identify solutions to
improve quality of care. The study methods have been
refined and used in other Botswana hospitals.