Assessment of client satisfaction with service delivery models at the Kenyatta National Hospital voluntary counseling and testing center
Introduction: High quality service is critical to client satisfaction by affecting retention and loyalty. The main service delivery models within the healthcare industry are vertical and the integrated. Kenyatta National Hospital (KNH) Voluntary Counseling and Testing (VCT) has used the vertical model since inception. However, with over 50% of HIV infected clients in Kenya unaware of their HIV status, the integrated model was adopted to improve VCT service delivery. We assessed the relationship between client satisfaction and service delivery models at KNH VCT, and evaluated staff views. Methodology: Cross-sectional analysis was carried out on 196 clients (stratified random sampling) and 24 VCT staff (convenience sampling). Participants were consented and structured questionnaires administered. Data analysis was conducted using SPSS (Statistical Package for Social Sciences) Version 16. Descriptive statistics were used to report the socio-demographic characteristics. Multivariate analysis using Pearson’s Chi-square test and Multivariate Analysis of Variance (MANOVA) was used to establish and test the strength of relationship between satisfaction and type of service delivery model. Results: Clients had a high level of satisfaction with KNH VCT services. People were rated highest (4.74) while physical infrastructure was rated lowest (4.13). There was no significant differences in satisfaction between vertical and integrated models except in overall booking process (p=0), waiting time before booking (p=0), waiting time before counseling (p=0), and adequacy of pre-test counseling session (p=0.003). The staff scored people highest (4.40) and physical infrastructure (3.97) with no significant differences between the two models. Waiting times was rated lowest overall. There was a significant difference in strength of relationship with clients consistently rating services higher than staff in all parameters. Conclusion: Clients rated KNH VCT services highly with staff receiving the highest ratings and physical infrastructure the lowest; similar to staff perspectives. Improvements in physical infrastructure and waiting times will likely improve overall satisfaction.