Direct Factors Influencing Patient Satisfaction with the Quality of Care in Kwango Health Centers in the Democratic Republic of the Congo

Abstract

Introduction

Patient satisfaction in health centers within the Kwango region remains concerning, characterized by high levels of dissatisfaction that structurally impede access to and optimal utilization of health services. This negative dynamic severely compromises the realization of Universal Health Coverage (UHC), which fundamentally depends on both the structural quality of care offered and the localized capability of individuals to benefit from it.

Purpose

This study aims to identify the direct factors that influence patient satisfaction with the quality of primary healthcare services in these centers, operationalized through Amartya Sen’s capabilities approach framework.

Methods

This is a quantitative, cross-sectional analytical study conducted via structured, face-to-face interviews. Data were collected from a randomized sample of 384 patients using an evaluation questionnaire integrated into the KoboCollect mobile application framework on Android devices. Statistical data analysis was executed using bivariate cross-tabulations and multi-variable logistic regression models.

Results

Multivariate logistic regression analysis identified several critical factors significantly escalating patient dissatisfaction, including: prolonged waiting times (p = .017, OR = 1.486, 95% { CI } [1.073, 2.057]), unavailability of medical staff (p = .011, OR = 1.302, 95% { CI } [0.782, 2.168]), insufficient clinical collaboration with patients (p = .001, OR = 2.794, 95% { CI } [1.738, 4.491]), poor clinical pain relief management (p = .001, OR = 3.321, 95%{ CI } [1.711, 6.445]), inadequate provider personal protective hygiene/glove usage practices (p = .018, OR = 2.260, 95% { CI } [1.150, 4.440]), structural center un-cleanliness (p = .001, OR = 2.109), missing handwashing installations (p = .001, OR = 2.084, 95% { CI } [1.419, 3.059]), un-affordable care pricing (p = .001, OR = 2.452, 95% { CI } [1.661, 3.619]), and local drug stockouts (p = .008, OR = 1.194). Conversely, explicit respect for patient privacy (p = .031, OR = 0.958, 95% { CI } [0.645, 1.422]) and functional post-discharge home monitoring (p = .002, OR = 0.472, 95% { CI } [0.294, 0.758]) acted as highly significant protective indicators, substantially reducing the risk of overall patient dissatisfaction.

Conclusion

The study mapped the explicit enabling (protective) and non-enabling (risk) parameters of patient satisfaction within Kwango primary health centers. To systematically advance regional patient satisfaction, urgent, targeted institutional interventions must be designed to correct these core infrastructure and relational failures, keeping line with the socio-evaluative principles of the capability approach.