Journal of Patient Care

Service quality in contracted facilities

World Congress on Patient Safety & Quality Healthcare

September 07-09, 2017 London, UK

Fauziah Rabbani, Nousheen Akber Pradhan, Shehla Zaidi, Syed Iqbal Azam and Farheen Yousuf

Aga Khan University, Pakistan

Posters & Accepted Abstracts: J Pat Care

Abstract:

Statement of the Problem: Essential quality components; skilled birth attendants, well-equipped health facilities, essential drugs and supplies, administrative capacity and referral linkages are missing in Pakistan�??s healthcare system. Contracting out services has become an attractive option for countries where there is a poor public health system and high private provider penetration. The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care Methodology & Theoretical Orientation: Using a cross-sectional study design, two rural health centers (RHCs) contracted out to an NGO in Pakistan were compared with four government managed RHCs. A quality care tool; Balanced Scorecard (BSC) was designed ( Fig 1.) to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson �?2, Fisher�??s Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Findings: Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients�?? inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p¼0.006). Contracted out facilities were found to be comparatively better than non-contracted facilities regarding various aspects such as Drugs, supplies, equipment availability, laboratory services and BemONC signal functions, HMIS records, waste disposal mechanisms and service delivery guidelines. Conclusion & Significance: The study shows that contracting out initiatives have the potential to improve MNH care. There is however, a need for sound governance and management to bridge staff capacity and to supervise staff-performance. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.