A multidimensional study of public satisfaction with the healthcare system: a mixed-method inquiry in Ghana

Abstract

Background Many governments in sub-Saharan Africa have recently sought to improve their health systems by increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known about the impact of these intended improvements on public perceptions about the healthcare systems. This article examines whether and why people of different socioeconomic and ideological backgrounds are satisfied (or not) with the current healthcare system in Ghana from a social ecological perspective. Method Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018. We used ordinal logistic regression and thematic analysis techniques to analyse the data. Results Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors (e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital); community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health personnel, financial constraints, perceived poor health facilities, and perceived inefficacy of services contribute to dissatisfaction with the healthcare system. Conclusion Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological perspectives by considering factors such as demographic profile, health needs, political orientation, issues of trust in the healthcare system, and the dynamics and impact of social relationships of populations concerned.

Distrust of banks among the unbanked and banked

“…The current study was conceptualized to address this gap in the literature by identifying the factors associated with perceptions of distrust of banks among unbanked and banked consumers. Using an adaptation of a socio-ecological systems perspective developed by Amoah et al (2021), a variety of variables were classified into one of the following five domains: (a) intrapersonal, (b) interpersonal, (c) institutional or organization, (d) community characteristics and (e) public policy environment. Two Boruta- 9 shows the variables that emerged as the most important descriptors of distrust from the analyses conducted in this study.…”

“…The figure shows the complexity associated with describing trust of banks. The conceptual framework is based on an adaptation of work published by Amoah et al (2021). Amoah and associates used a socio-ecological systems approach to understand the correlates and perceptions of public satisfaction with the healthcare system.…”

“…The figure shows the complexity associated with describing trust of banks. The conceptual framework is based on an adaptation of work published by Amoah et al. (2021).…”

“…6. Amoah et al . (2021, p. 3) referred to satisfaction as contentment with the overall characteristics of existing services, policies, institutions, personnel, facilities, and other factors.…”

Socioeconomic inequality in public satisfaction with the healthcare system in China: a quantile regression analysis

“…Owing to these features, public satisfaction has been regarded as an important indicator for monitoring the performance of a nation's healthcare system [3,6,11], as well as a key measure of government administration performance [4] and social welfare [12]. Meanwhile, significant variations among the association factors have been observed across countries [13,14]. Populations with financial and health vulnerabilities were found to have lower level of satisfaction with the healthcare system even among European countries [13].…”