Browsing by Author "Agok, Thon Paul."

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Assessment of Quality of Care in Private Clinics in Juba, Republic of South Sudan.
(International Health Sciences University., 2014-11) Agok, Thon Paul.
Introduction/background: Private health care practice is one of the main elements of health care financing strategy in the Republic of South Sudan. Quality assessment of care in this sector is an essential measure of care delivery to patients. Since there is a growing competition within the private health care practice in Juba, patients' satisfactions and quality of care delivered by the health care providers accounts for the patient outcomes. Differences in quality of services delivered in the private practice is thought to reflect differences in safety, effectiveness, efficiency and timely. There had been no study done in Juba on quality of care assessment despite the rising in private health care practice. Donabedian's model of interrelationship between the triad (clinic, the clinician, and the patient) is employed in this study to measure the quality of care performance by the health care providers. Main objective: is to assess the quality of care in private clinics in Juba city. The significance of this study is to improve the health care outcomes and effectiveness of health care services in private clinics as well help identify point of weakness that call for strengthening in private practice. Methodology: A cross sectional quantitative study was used to assess the quality of care in private clinics in Juba with regards to the structure, care process and the patients' satisfaction which involved 138 patients and 138 private Clinics/hospitals in 3 payam (Munuki, Juba and Kator) that make up Juba City Council. Research data were collected using Interview questionnaire and the Observation Checklist administered by the principal researcher and his assistants. Results: The study showed that there was lack of laboratory units in 22.5% of private clinics. Growths shortage of staffs, several clinics and personnel operates without licenses (37.0%). No running water and electricity in 16.7% of clinics. There was also lack of basic medical equipments and facilities for consultation, diagnosis, infection control, sterility and waste disposal. However, patients were generally satisfied with the quality of services rendered by the private clinics, although they were not contented with laboratory investigation, waiting time, cleanliness of private clinics, attitudes, privacy and follow-up. Conclusion: Majority of the patients assessed had good perception about the private clinics in Juba, however; a small percentage of them complained about the laboratory, examinations and follow-up. All private clinics were understaffed; several of them without updated operational/practicing licenses, poor infection control measures, poor sanitation, lack of medical record keeping and inadequate basic medical facilities generally. Recommendations: National Ministry of Health should set standard requirements for operating private clinics from human resources aspect to medical facilities necessary for running a clinic. Also set up Medical and Dental Council to regulate the medical practice in Juba and other parts of South Sudan. The MOH should also make the clinical guidelines, standard protocols available to all private clinics and monitor for implementation. Setting up of Continuous Medical Education programs for skills updates The State Ministry of Health for CEG to re-evaluate the standard requirements for registering clinics, supervised, and monitors to make sure that the doctors who registered clinics are working there and that the facilities that were found during registration are still available at the clinics. Private clinics are recommended to hire more qualified medical staffs with current licenses to curve under staffing. Setup a medical record information system, equipped laboratories with modern machines, and purchase equipment for diagnosis, sterility, nursing and midwife kits etc. Established sit for hand wash, toilets and waste disposal. Good supervision and performance appraisal to evaluate the staffs' performances. Areas of further research: Area of medical resource utilization in private clinics, laboratory requests and conflict of interest. Area of polypharmacy and its effects on patients' economy. Key words: Quality of Care Assessment, in Private Clinics, in Juba City, Republic of South Sudan for hand wash, toilets and waste disposal. Good supervision and performance appraisal to evaluate the staffs' performances.