Professionalism, patient satisfaction and quality of health care: Experience during Zimbabwe's structural adjustment programme

Mary Travis Bassett, Leon Bijlmakers and David M. Sanders

Social Science & Medicine, 1997, vol. 45, issue 12, 1845-1852

Abstract: In 1991, Zimbabwe embarked on a structural adjustment programme. In the health sector, collection of fees was enforced and fees were later increased. Utilisation subsequently declined. This paper examines the perceptions of both government nurses and health care consumers regarding the impact of adjustment on overall quality of care, including nurse professionalism, the nurse-client relationship and patient satisfaction with care. These issues were explored in a series of focus group discussions held in December 1993, about three years after policy reforms. The discussions suggested many areas of shared concern (fees, drug availability, waiting times), but divergent views regarding the process of care. Nurses were concerned mainly with overwork and patient ingratitude, and failed to recognise nurse behaviour as a major source of patient dissatisfaction. Community women saw nurses as hardened and indifferent, especially in urban areas. These differences are rooted in the perceived class differences between nurses and the communities they serve, but appear to have sharpened during the period of structural adjustment.

Keywords: professionalism; patient; satisfaction; quality; of; care; structural; adjustment; Zimbabwe; Africa (search for similar items in EconPapers)
Date: 1997
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