Abstract
Background
Many governments in sub-Saharan Africa have recently sought to improve their health systems by increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known about the impact of these intended improvements on public perceptions about the healthcare systems. This article examines whether and why people of different socioeconomic and ideological backgrounds are satisfied (or not) with the current healthcare system in Ghana from a social ecological perspective.
Method
Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018. We used ordinal logistic regression and thematic analysis techniques to analyse the data.
Results
Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors (e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital); community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health personnel, financial constraints, perceived poor health facilities, and perceived inefficacy of services contribute to dissatisfaction with the healthcare system.
Conclusion
Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological perspectives by considering factors such as demographic profile, health needs, political orientation, issues of trust in the healthcare system, and the dynamics and impact of social relationships of populations concerned.
Many governments in sub-Saharan Africa have recently sought to improve their health systems by increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known about the impact of these intended improvements on public perceptions about the healthcare systems. This article examines whether and why people of different socioeconomic and ideological backgrounds are satisfied (or not) with the current healthcare system in Ghana from a social ecological perspective.
Method
Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018. We used ordinal logistic regression and thematic analysis techniques to analyse the data.
Results
Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors (e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital); community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health personnel, financial constraints, perceived poor health facilities, and perceived inefficacy of services contribute to dissatisfaction with the healthcare system.
Conclusion
Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological perspectives by considering factors such as demographic profile, health needs, political orientation, issues of trust in the healthcare system, and the dynamics and impact of social relationships of populations concerned.
| Original language | English |
|---|---|
| Article number | 1320 |
| Journal | BMC Health Services Research |
| Volume | 21 |
| Issue number | 1 |
| Early online date | 9 Dec 2021 |
| DOIs | |
| Publication status | Published - Dec 2021 |
Bibliographical note
Publisher Copyright:© 2021, The Author(s).
Funding
This study was funded through Lingnan University Seed Grant (Grant code: 102338). The study also received funding support from Lingnan University through the Lam Woo Research Fund-Individual Grant (Grant code: LWI20014). Both fundings were offered to the first author. The funders played no role in the study design; data collection, analyses, and interpretation; in the writing of the manuscript, or in the decision to publish the results.
Keywords
- Public satisfaction
- Healthcare system
- Social ecology
- Social Capital
- Ghana
- Social capital
