Assessment of quality of services in private clinics in Addis Ababa, Ethiopia.

Involvement of the private sector in provision of health services has progressively increased in many developing countries including Ethiopia. Promotion of the private sector involvement is also one of the elements in the health care financing strategy in Ethiopia. A cross sectional descriptive study was done on quality of care in private clinics in Addis Ababa during the period of April, 2000. Different levels of clinics were randomly selected and assessments were done on structural aspects, performance of health workers in polyclinic outpatient department and patients satisfaction with the medical care given. It was found that most clinics fulfill the requirements of the Ministry of Health (MOH) with regard to staffing, equipment and medications. Nevertheless few clinics were found not to fulfill the minimum requirements put in the guideline. With regard to performance, various aspects of mal-performance were observed where the highest problem was concerning treatments given to patients. High rates of satisfaction were generally reported in all aspects of medical care that include: waiting time, cleanliness of facilities and equipment, courtesy and competence of providers and the effectiveness of the services provided. Relatively lower proportion of respondents has reported dissatisfaction with the services provided. The aspects of the private sector services for which dissatisfaction was reported were too high service charge and too little information given about nature and prospect of diseases. These imply that the private facilities included in the study are generally doing well in terms of structural as well as in most process attributes of quality while provider-patient interaction and competitive pricing of services seem to be areas that need improvement. Findings are discussed in comparison with findings in public and private health facilities in Ethiopia and other countries. In addition, the inclusion of periodic assessment of process of care in quality control measures is recommended.