Public–Private Partnership in Health Care: A Comparative Cross-sectional Study of Perceived Quality of Care Among Parents of Children Admitted in Two Government District-hospitals, Southern India

Baliga, B. Shantharam; Ravikiran, S. R.; Rao, Suchetha; Coutinho, Anitha; Jain, Animesh

doi:10.7860/jcdr/2016/17124.7250

Cited by 16 publications

(15 citation statements)

References 16 publications

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“…Given the considerable share of patients using private facilities and the gap of coverage of BPHS and EPHS to reach more of the population in Afghanistan, policy reforms should take into consideration private health facilities, for example, through public-private partnerships (PPP) in the financing and delivery of health services. Some studies show the favorable impact of PPP in improving quality and coverage of care in some developing countries [37–39]. Afghanistan has put PPP as one of their priorities in health care reform, and will need to learn lessons of PPP in other countries to accelerate its pace in implementing PPP in the health sector.…”

Section: Discussionmentioning

confidence: 99%

An equity analysis of utilization of health services in Afghanistan using a national household survey

et al. 2016

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BackgroundAfghanistan has made great strides in the coverage of health services across the country but coverage of key indicators remains low nationally and whether the poorest households are accessing these services is not well understood.MethodsWe analyzed the Afghanistan Mortality Survey 2010 on utilization of inpatient and outpatient care, institutional delivery and antenatal care by wealth quintiles. Concentration indexes (CIs) were generated to measure the inequality of using the four services. Additional analyses were conducted to examine factors that explain the health inequalities (e.g. age, gender, education and residence).ResultsAmong households reporting utilization of health services, public health facilities were used more often for inpatient care, while they were used less for outpatient care. Overall, the utilization of inpatient and outpatient care, and antenatal care was equally distributed among income groups, with CIs of 0.04, 0.03 and 0.08, respectively. However, the poor used more public facilities while the wealthy used more private facilities. There was a substantial inequality in the use of institutional delivery services, with a CI of 0.31. Poorer women had a lower rate of institutional deliveries overall, in both public and private facilities, compared to the wealthy. Location was an important factor in explaining the inequality in the use of health services.ConclusionsThe large gap between the rich and poor in access to and utilization of key maternal services, such as institutional delivery, may be a central factor to the high rates of maternal mortality and morbidity and impedes efforts to make progress toward universal health coverage. While poorer households use public health services more often, the use of public facilities for outpatient visits remains half that of private facilities. Pro-poor targeting as well as a better understanding of the private sector’s role in increasing equitable coverage of maternal health services is needed. Equity-oriented approaches in health should be prioritized to promote more inclusive health system reforms.

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Section: Discussionmentioning

confidence: 99%

An equity analysis of utilization of health services in Afghanistan using a national household survey

et al. 2016

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“…In an intervention aimed at improving quality of post-abortion family planning provision, women reported higher satisfaction due to their improved experiences of counselling and time spent with provider: 69% of women reported being given clear care instructions post-intervention compared to 58% of women at baseline [ 55 ]. In public-private partnership facilities in a district hospital in Southern India, waiting time for treatment and the manner of other support staff [compared to physician or nurse] were the most significantly associated factors with satisfaction among parents of admitted children [ 56 ].…”

Section: Resultsmentioning

confidence: 99%

Experiences of private sector quality care amongst mothers, newborns, and children in low- and middle-income countries: a systematic review

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Maliqi

et al. 2021

BMC Health Serv Res

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Background Experience of care is a pillar of quality care; positive experiences are essential during health care encounters and integral to quality health service delivery. Yet, we lack synthesised knowledge of how private sector delivery of quality care affects experiences of care amongst mothers, newborns, and children. To fill this gap, we conducted a systematic review that examined quantitative, qualitative, and mixed-methods studies on the provision of maternal, newborn, and child health (MNCH) care by private providers in low- and middle-income countries (LMICs). This manuscript focuses on experience of care, including respectful care, and satisfaction with care. Methods Our protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Searches were conducted in eight electronic databases (Cumulative Index to Nursing and Allied Health, EconLit, Excerpta Medica Database, International Bibliography of the Social Sciences, Popline, PubMed, ScienceDirect, and Web of Science) and two websites and supplemented with hand-searches and expert recommendations. For inclusion, studies examining private sector delivery of quality care amongst mothers, newborns, and children in LMICs must have examined maternal, newborn, and/or child morbidity or mortality; quality of care; experience of care; and/or service utilisation. Data were extracted for descriptive statistics and thematic analysis. Results Of the 139 studies included, 45 studies reported data on experience of care. Most studies reporting experience of care were conducted in India, Bangladesh, and Uganda. Experiences of private care amongst mothers, newborns, and children aligned with four components of quality of care: patient-centeredness, timeliness, effectiveness, and equity. Interpersonal relationships with health care workers were essential to experience of care, in particular staff friendliness, positive attitudes, and time spent with health care providers. Experience of care can be a stronger determining factor in MNCH-related decision-making than the quality of services provided. Conclusion Positive experiences of care in private facilities can be linked more broadly to privileges of private care that allow for shorter waiting times and more provider time spent with mothers, newborns, and children. Little is known about experiences of private sector care amongst children. Trial registration This systematic review was registered with the PROSPERO international prospective register of systematic reviews (registration number CRD42019143383).

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“…On the other hand, there is evidence that parental satisfaction in provincial centers is higher than in national specialist centers, probably due to the lower severity of cases and less stressful working conditions (34,35). Moreover, a greater satisfaction of patients in hospitals with a private-publicpartnership than in public hospitals has already been previously reported (36). Among other aspects this may have influenced parental satisfaction with discharge preparation (37) and health workers' care and behavior (38,39).…”

Section: Discussionmentioning

confidence: 95%

Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N

et al. 2021

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Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains.Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided.Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67–5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33–5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience.Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.

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Public–Private Partnership in Health Care: A Comparative Cross-sectional Study of Perceived Quality of Care Among Parents of Children Admitted in Two Government District-hospitals, Southern India

Cited by 16 publications

References 16 publications

An equity analysis of utilization of health services in Afghanistan using a national household survey

An equity analysis of utilization of health services in Afghanistan using a national household survey

Experiences of private sector quality care amongst mothers, newborns, and children in low- and middle-income countries: a systematic review

Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N

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