Quality disparity in terms of clients’ satisfaction with selected exempted health care services provided in Ethiopia: Meta-analysis
Bibliographic record
Abstract
Introduction In Ethiopia; even though utilization of health care services has been improved after the introduction of user fee exemption, little is known about the quality of the services. There are fragmented studies on the output dimension of quality of health care services particularly on clients’ satisfaction. Therefore this study aims to assess overall quality (in terms of clients’ satisfaction) and its disparity among users of selected exempted health care services provided in Ethiopia. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline was used to undertake this study. Both published and unpublished articles conducted in Ethiopia on the quality of health care services in terms of clients’ satisfaction dimensions were searched. A total of 750 articles were retrieved through international databases (Scopus, MEDLINE/PubMed, Science Direct, Google Scholar and Cochrane Library) and national digital library repositories (Addis Ababa University’s digital library repository); 703 of which were excluded while only 47 articles were included in the meta -analysis. The search for articles was conducted during the period 03 December 2019 to 28 January 2020. For methodological qualities of the included articles assessment, a modified version of the Newcastle-Ottawa Scale adapted for cross-sectional studies was used. R version 3.6.1 and stata version 14 soft wares were used for analysis. A random-effects model was used to calculate pooled estimates. The I2 tests were used to assess the heterogeneity of the studies. Results The pooled overall prevalence of included 47 studies revealed that clients’ satisfaction among users of selected exempted health care services in Ethiopia was 70% (95% CI: 64, 74%). In subgroup analysis; the lowest prevalence of clients’ satisfaction was observed among users of obstetrics maternal health care services with the prevalence of 65.04% (95% CI: 57.50, 72.58). Conclusion This study found that more than one-third of respondents; was not satisfied with exempted health care services. There is slight difference in satisfaction of clients across type of exempted health care services and regions. Policy and decision makers in Ethiopia shall design strategies to optimize quality of health care services besides exemption of its costs.it is also strongly recommend that a special emphasis shall be given to obstetric health care services provision. Moreover, concerned stakeholders’ (ministry of health, etc.) should strengthen compassionate respectful care provision in public health facilities; beside to removing user fees.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.046 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.054 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".