Beruflich Dokumente
Kultur Dokumente
047
Sunil Mehra1, Ruchi Sogarwal2, Vandana Nair3, Mahasweta Satpati4, Ramanand Tiwari4,
Kaushlendra Dwivedi4
1
Executive Director, Senior Technical Advisor, 3Assistant Director, 4Regional Manager, MAMTA Health Institute for
2
ABSTRACT
Study analyzes key determinants of Youth Friendly Health Services that influence the client's satisfaction
level. Data from 120 clients were collected from selected four districts of Uttar Pradesh and Bihar States
of India. Multivariate logistic regression model was applied to understand the independent effect of
important predictors. Overall only 32.0% clients were satisfied with the services. Positive association is
observed with the educational status of the clients. If the parents/guardians are supportive, clients are
4.4 times more likely to get overall satisfaction from the services. 92% clients are less likely to get
satisfied, if there is a fear of privacy disclosure to parents. Hence, privacy and confidentiality in services
and support of parents/guardians play a significant role in affecting client satisfaction as compared to
other determinants of the services. Study will enable decision-makers to improve the quality of health
care effectively, keeping a balance between providers' and clients' perspectives.
In the present article, data from baseline survey of log [p/(1-p)] = b0 + b1*x1 + b2*x2 + ... + bk*xk + ei
intervention project on “Improving Reproductive and
Sexual Health of Young People by Increasing the Age where b 1, b 2, b 3 etc. are the logistic regression
at Marriage in India” has been utilized. Since 2008, coefficients and log [p/(1-p)] is called the log odds or
MAMTA-Health Institute for Mother and Child12 is logit of the event. Hosmer - Lemeshow test was applied
being implementing the project with the goal to improve to understand the goodness of fit of the model.
adolescent sexual and reproductive health by increasing
age at marriage and delayed first pregnancy among RESULTS
young people aged 10-24 years.
a. Socio-demographic characteristics of clients
The baseline data was collected by trained by “Satisfaction level”
researchers during April-July, 2012 from Hardoi and
In all, 32.0% clients reported that they were satisfied
Siddharth Nagar districts in Uttar Pradesh and
with the services received from the ARSH clinics. Female
Nalanda and Vaishali districts in Bihar state. Again
clients reported more satisfaction (36.4%) in contrast to
from each selected district, one Primary Health Center
male clients (25.4%). Positive association was observed
(PHC) was covered to collect data from the clients. A
with the educational status of the clients. Clients who
consecutive sample of 120 clients consisting equal
were educated up to intermediate and above reported
number of males and females was interviewed from
high level (37.2%) of satisfaction in comparison to the
selected PHCs, however, the question on satisfaction
clients who were educated up to middle school (25.0%)
level was reported by 114 clients only.
and high school (27.0%). Differentials in satisfaction
Statistical Analysis were seen by the religious background of the clients.
25.0% Muslim clients and 30.9% Hindu clients reported
Chi-square (x2) test was used to check the association to be satisfied. Varying level of client satisfaction has
between the variables. The service related variables been reported by caste, marital status and status of the
which are found significantly associated with client studentship. Less percentage (28.1%) of student clients
satisfaction as a result of x2 were used in Multivariate were reportedly satisfied in comparison to the clients
logistic regression model to assess the likelihood of who were not students (34.0%). No clear pattern was
getting satisfied from the services using the observed by income level of the household. (Table 1)
Table 1: Socio-demographic Characteristics of Clients by ‘Satisfaction level’
Results from multivariate logistic regression are three times more likely to get satisfied. Even after
analysis in which only significant Odds Ratio (OR) of controlling the effect of privacy, information and services
three different regression models is shown in Table-3. demanded and availability of waiting area, the also the
Model I presented unadjusted OR for client satisfaction likelihood of getting satisfied is more among the clients
whereas Model II presents adjusted OR for three whose parents and guardians were supportive
indicators i.e. ‘Staff at YFHS informing the Parents/ (Model-II). In Model III after controlling the effect of
Guardians if an unmarried visits the Facility’; socio-economic and demographic characteristics of the
‘Provision of information and services demanded’; and clients, ‘support of parents/guardians’ and ‘privacy
‘Availability of waiting area’. In Model III OR was and confidentiality’ are significantly associated with
adjusted for all important socio-economic and the client satisfaction. If the parents/guardians are
demographic characteristics. supportive, clients are 4.4 times more likely to get
satisfied from the services. Further, 92% clients are less
Model I shows that ‘if Parents/Guardians are likely to get satisfied, if fear exists of getting privacy
supportive for Reproductive Health Services’, clients disclosed to parents.
Note: Only significant Odds Ratios are Presented in the Table; *p<0.05, **p<0.10; ®Reference category;
Model III à Adjusted for Characteristics b, c, d, Age of the Clients, Sex of the Clients, Educational Qualification,
Religion, Marital Status, Currently Student and Monthly Income of Household.
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