The article “Assessment of Patients’ Satisfaction with the Quality and Care of UNRWA Primary Healthcare Services – Question of Palestine” provides a comprehensive analysis of the quality of healthcare services provided to Palestine refugees by The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). This assessment aimed to evaluate patient satisfaction, identify areas for improvement, and enhance the overall quality of healthcare services across four fields of operation (FOs): Jordan, Lebanon, Syria, and the West Bank (including East Jerusalem). Due to the war in October 2023, the Gaza FO was excluded from the survey.
Accessibility of Healthcare Services
Geographic accessibility of healthcare services is generally high, with 90% of the responses across the fields of operation being positive. However, physical accessibility such as elevators and ramps shows significant deficits in Lebanon (23%) and Syria (15%). Elevator functionality was critically low, particularly in Lebanon (8%) and entirely non-existent in Syria, which poses challenges for patients with mobility issues. Accessible toilets for persons with disabilities are insufficient, with Syria (18%) lagging far behind the West Bank (including East Jerusalem) (89%).
Social accessibility, on the other hand, is strong, with 98% of patients reporting no social barriers. Operational hours are deemed convenient by 98% of respondents, with a noticeable preference for Saturday visits. In-person consultations are highly preferred over telemedicine, attributed to the perceived comfort and security that face-to-face interactions provide. This preference underscores the importance of maintaining robust physical healthcare facilities while exploring ways to integrate technology effectively.
Interpersonal Skills of Healthcare Providers
High levels of satisfaction were noted with healthcare providers’ communication skills and their ability to listen, which reached 100% in Lebanon and the West Bank (including East Jerusalem). This reinforces the importance of effective communication in healthcare settings. Language comprehension by staff also received positive feedback across all fields of operation, ensuring that patients feel understood and valued. However, satisfaction with the time allowed for patient expression saw a slight dip, especially in Syria, where it stood at 90%, indicating a need for providers to allocate more time for patient interactions.
Privacy during physical examinations was consistently rated positively (97%), an essential factor in building patient trust and making them feel secure. Nevertheless, the availability of chaperones during examinations revealed significant concerns, particularly in Syria (38%) and Jordan (53%). This gap could impact patient comfort, particularly for vulnerable groups, and indicates an area needing urgent address to enhance the overall patient experience and safeguard their dignity.
Quality of Healthcare and Compliance
Administrative quality varied notably across locations, with Lebanon scoring highest in updating personal information at 60%. This variation underscores the need for standardized administrative procedures to ensure consistent service quality. Basic medical care compliance with clinical guidelines was exceptionally high in Syria at 99%, showcasing adherence to essential healthcare protocols. Referral mechanisms were strongest in the West Bank (including East Jerusalem) at 97%, indicating an effective system for directing patients to appropriate care levels.
The Family Health Team (FHT) approach received an overall positive response of 88%, with Jordan showing the lowest satisfaction at 51%. This variation suggests the need for targeted interventions to strengthen the FHT model in Jordan. Inclusivity and sensitivity towards patients averaged 72%, though awareness of Gender-Based Violence (GBV) services was critically low at 12%. These findings highlight the necessity of raising awareness and ensuring service accessibility to address the specific needs of vulnerable populations.
Compliance with Standards and Best Practices
Compliance with healthcare standards and best practices showed significant variation across the fields of operation. Jordan had the lowest compliance at 68%, with marked deficiencies in radiology services and reliance on obsolete equipment, factors that could compromise healthcare delivery. Lebanon followed close at 72%, struggling primarily in physiotherapy and radiology services, underlining the need for targeted quality improvement initiatives in these areas. Syria performed slightly better at 77% but faced similar challenges that require immediate action to ensure the standardization of healthcare practices.
The West Bank (including East Jerusalem) led with 82% compliance but still needed enhancements in radiology services, indicating room for improvement even in the highest-performing regions. Specialized care compliance, particularly in child healthcare, was strong in Syria and Jordan, signifying effective pediatric healthcare systems in place. Non-Communicable Diseases (NCD) management compliance was high in Lebanon at 88% but lower in Syria at 80%, demonstrating a need for consistent management strategies across the FOs. Oral health compliance varied significantly, being highest in Syria (100%) and lowest in Jordan (65%), pointing to disparate levels of care which must be harmonized to ensure uniform service quality.
Facility Management
Facility management standards varied across the fields of operation, with Jordan and Lebanon showing high standards at 89% and 93% positive responses, respectively. These high ratings reflect well-maintained facilities and a focus on ensuring a conducive environment for healthcare delivery. However, Syria had the lowest average at 79%, indicating significant issues in facility maintenance and cleanliness that need immediate attention. This poor performance underscores the need for strategic improvements in infrastructure and facility management practices.
The West Bank (including East Jerusalem) performed well but showed a low rate of patient feedback at 17%, which could hinder continuous quality improvement efforts. Effective facility management practices include regular maintenance, stringent cleanliness protocols, and a mechanism for capturing patient experiences and feedback. Addressing these issues is critical to maintaining a high standard of healthcare delivery across all fields of operation.
Patient Flow Analysis
One of the key challenges identified in the assessment was patient flow and waiting times. Jordan recorded the longest average waiting time at 147 minutes, followed by Lebanon at 96 minutes, the West Bank (including East Jerusalem) at 87 minutes, and Syria at 81 minutes. These prolonged waiting times and scheduling issues are prominent challenges affecting patient experience and satisfaction across all fields of operation. The waiting times suggest a need for improved scheduling systems and patient flow management to enhance efficiency and reduce patient wait times.
Addressing these challenges involves a multifaceted approach, including optimizing appointment scheduling, streamlining administrative processes, and leveraging technology for better patient management. Implementing these strategies can significantly reduce waiting times, improve patient satisfaction, and enhance the overall efficiency of healthcare services provided by UNRWA.
Main Findings
The Patient Satisfaction Survey revealed critical insights into the quality and care of UNRWA healthcare services. High geographic and social accessibility are positive aspects, but there is a clear need for improvements in physical infrastructure. Enhanced facilities would ensure inclusivity and better cater to individuals with disabilities. While staff communication and listening skills are highly rated, there’s a pressing need to improve patient expression time, privacy measures, and availability of chaperones. These enhancements are essential to bolster patient trust and comfort, leading to a more responsive and patient-centered approach.
Significant variations in the quality of administrative and clinical care across the fields of operation highlight the need for standardized procedures. Ensuring uniformity in service delivery can improve the overall patient experience. Compliance with best practices is higher in areas like child healthcare and NCD management; however, specialized services like radiology and physiotherapy lag behind, indicating a potential gap in service delivery that needs attention. Facility management shows disparities, particularly in Syria, necessitating targeted improvements in maintenance and cleanliness. Lastly, long waiting times and scheduling inefficiencies are widespread challenges that impact patient flow and experience.
Recommendations
The article titled “Assessment of Patients’ Satisfaction with the Quality and Care of UNRWA Primary Healthcare Services – Question of Palestine” offers a thorough evaluation of healthcare services provided to Palestinian refugees by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). The primary aim of this assessment was to gauge patient satisfaction, pinpoint areas that need enhancement, and ultimately improve the quality of healthcare services across four operational fields (FOs): Jordan, Lebanon, Syria, and the West Bank, which includes East Jerusalem.
Notably, the Gaza FO was excluded from this survey due to the adverse impacts and disruptions caused by the war that erupted in October 2023. This exclusion was necessary to maintain the accuracy and reliability of the survey data, ensuring that the specific challenges faced by the Gaza region during the conflict would not skew the overall results.
The article emphasizes the importance of understanding patient perspectives to drive improvements in healthcare delivery. By analyzing patient feedback, UNRWA aims to address issues and implement changes that will enhance the healthcare experience for Palestinian refugees. This approach underscores the agency’s commitment to providing high-quality primary healthcare services amidst challenging circumstances. The study highlights the ongoing efforts and dedication required to meet the healthcare needs of Palestinian refugees spread across multiple countries.
