Journal Press India^®

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Purpose: The general objective of this paper was to assess customer service quality and customer satisfaction of health service delivery in Tanzania focusing on the hospitals that provide health services to the members of NHIF. Specifically, the paper addresses two issues: firstly, to examine customer satisfaction on the basis of services offered to the members of NHIF by the hospitals which were studied; and secondly, it attempts to measure the customer satisfaction level through SERVQUAL model dimensions.

Design/Methodology/Approach: The case study was used whereby data collection involved primary data and secondary data. In addition, the SERVQUAL model, which was proposed by Parasuraman, Zeithaml, & Berry (1988) was applied. The model presupposes that “service quality is the difference between expectations and performance relating to quality dimensions” (Dudo & Amankwah, 2011, p. 28).

Findings: The results show that, most of the respondents were dissatisfied with the services offered by selected hospitals under NHIF. The complaints escalated by the patients are mainly associated with timing of delivery and quality of services, corruption, and usage of inappropriate language by the hospital staff with the patients. The SERVQUAL model dimensions showed that, with respect to tangibility, 45.7% NHIF members who get health services from the selected hospitals were not satisfied with the environment and premises of the selected hospitals. With respect to reliability, the findings show that, 55.7% of NHIF members were not satisfied; and about 57.2% were not satisfied with the hospital employees’ timeliness in delivering services. The other attributes of the model indicated that minority of the respondents (28.6%), were not satisfied with the knowledge of employees. Finally, based on the empathy, the results indicate that 58.3% of NHIF members disagreed that the staff members understand the needs of the customers.

Research Limitations/Implications: This study was limited to one district i.e. Temeke in Dar es Salaam region in Tanzania. However, given the methodology used, the findings shed light on customer care and satisfaction in provision of health services for the members of National Health Insurance Fund.

Practical Implications: “If physical facilities, including cleanliness, modern equipment, and the general feeling that the hospital is in a good physical condition, are well perceived then patient satisfaction increases” (Naidu, 2009, p. 368). If the hospitals’ employees do not care for the needs of the customers, it would affect the customer satisfaction in the health service delivery. This necessitates the prompt resolution of the complaints raised by the customers in addition to provision of adequate information to them regarding the means of settlement of their grievances within the organization. In case the aggrieved customers are dissatisfied with the corrective action taken by the service provider in correspondence to their complaints, they should have the access to their rights of availing alternative remedies.

 Originality/Value: The researchers developed the title, objectives, and research questions, collected and analyzed data and the results of the research are as reported.

Keywords

Health Service Delivery, Customer Satisfaction.

1. Adam, J., & Kamuzora, F. (2008). Research Methods for Business and Social Studies. Tanzania: Mzumbe University Tanzania. 
2. Aliman, N. K., & Mohamad, W. N. (2013). Perceptions of service quality and behavioral intentions: A mediation effect of patient satisfaction in the private health care in Malaysia. International Journal of Marketing Studies, 5(4), 15. 
3. Amponsah, E. N., & Hiemenz, U. (2009). Determinants of consumer satisfaction of health care in Ghana: Does choice of health care provider matter? Global Journal of Health Science, 1(2), 50-60.
4. Ananth, A., Ramesh, R., & Prabaharan, B. (2010). Service quality gap analysis in private sector bank - a customer perspective. Indian Journal of Commerce and Management Studies, 2(1), 245-252. 
5. Andaleeb, S. (2008). Caring for children: a model of healthcare service quality in Bangladesh. International Journal for Quality in Health Care, 20(5), 339-345. 
6. Auka, D. O., Bosire, J. N., & Matern, V. (2013). Perceived service quality and customer loyalty in retail banking in Kenya. British Journal of Marketing Studies, 1(3), 32-61.
7. Belkin, G. S., & Morone, J. A. (1994). The Politics of Healthcare Reforms: Lessons from the Past, Prospects for the Future. North Carolina, USA: Duke University Press. ISBN-13: 978-0822314899.
8. Byers, A. L. Sheeran, T., Mlodzianowski, A. E., Meyers, B. S., Nassisi, P., & Bruce, M. L. (2008). Depression and risk for adverse falls in older home health care patients. Research in gerontological nursing, 1(4), 245-251.
9. Carrin, G., & James, C. (2005). Social health insurance: Key factors affecting the transition towards universal coverage. International Social Security Review, 58(1), 45–64. 
10. Carrin, G., Buse, K., Heggenhougen, K., & Quah, S. R. (2009). Health system, Policy, finance and organization. Retrieved from http://www.who.int/health _financing/documents/cov-hsyspolfinorg/en/, Accessed on January 10, 2018. 
11. Cul, C., C., Lewis, B. R., & Park, W. (2003). Service quality measurement in the banking sector in South Korea. International Journal of Bank Marketing, 21(4), 191-201. 
12. Dash, S. K., Parwez, A., & Parwez, F. (2013). Service quality measurement and its evaluation of leading private banks of India in Delhi and NCR region: An analytical study. International Journal of Contemporary Business Studies, 4(1), 24-52.
13. Edvardsson, B. O. (1998). Service quality improvement. Managing Service Quality: An International Journal, 8(2), 142-149. 
14. Fick, G. R., & Brent Ritchie, J. R. (1991). Measuring service quality in the travel and tourism industry. Journal of Travel Research, 30(2), 2-9. 
15. Fowdar, R. (2005). Identifying health care attributes. Journal of Health and Human Services Administration,  27(4), 428-443.
16. Gilbert, F. W., Lumpkin, J. R., & Dant, R. P. (1992). Adaptation and customer expectations of health care options. Journal of Health Care Management, 12(3), 46-55.
17. Gill M. (1993). Purchasing for quality: still in the starting blocks? Quality in Health Care, 2(2), 179-182.
18. Kish, L. (1965). Survey Sampling. New Jersey, USA: Wiley & Sons. 
19. Kumar, M., Kee, T. F., & Manshor, T. A. (2009). Determining the relative importance of critical factors in delivering service quality of banks: an application of dominance analysis in SERVQUAL model. Managing Service Quality: An International Journal, 19(2), 211-228. 
20. Kuo, Y. F., Wu, C. M., & Deng, W. J. (2009). The relationships among service quality, perceived value, customer satisfaction, and post-purchase intention in mobile value-added services. Computers in human behavior, 25(4), 887-896.
21. Lal, M. (2001). Safety and health culture through training and development. Delhi Business Review, 2(2), 1-3. 
22. Lee, H., Lee, Y., & Yoo, D. (2000). The determinants of perceived service quality and its relationship with satisfaction. Journal of services marketing, 14(3), 217-231.
23. Leichter, H. M. (1979). A comparative approach to policy analysis: Health care policy in four nations. Cambridge: Cambridge University Press. 
24. Longenecker, C. O., & Neubert, M. (2003). The management development needs of front line managers: voices from the field. Career Development International, 8(4), 210-218. 
25. Madan, M., & Kumari, S. (2012). Determinants of retail customer satisfaction: A study of organized retail outlets in Delhi. Delhi Business Review, 13(1), 117-126. 
26. Mascarenhas, O. A. (1993). Marketing health care to employees: the structure of employee health care plan satisfaction. Marketing Health Services, 13(3), 34-46. 
27. Mbogori, F. K., Ombui, K., & Iravo, M. A. (2015). Innovative Strategies Influencing Performance of National Hospital Insurance Fund in Nairobi Country Kenya. Retrieved from http://www.ijsrp.org/research-paper-1015.php?rp=P464738, Accessed on May 13, 2017. 
28. Mengi, P. (2009). Customer Satisfaction with Service Quality: An Empirical Study of Public and Private Sector Banks. The IUP Journal of Management Research, 8(9), 7-17. 
29. Milakovich, M. E. (2012). New technologies for improving public service and participation. New York: Routledge. 
30. Millas, A. (2013). The link between services quality and customer satisfaction in the retail banking in Tanzania, case study of CRDB bank. Retrieved from http://repository.out.ac.tz/1052/1/millas_final.pdf, Accessed on June 20, 2017.
31. Moeller, S. (2008). Customer integration—a key to an implementation perspective of service provision. Journal of Service Research, 11(2), 197-210.
32. Ndubisi, O. N. (2006). Effect of gender on customer loyalty: a relationship marketing approach. Marketing intelligence & planning, 24(1), 48-61. 
33. Neal, W. D. (1998). Satisfaction be damned, value drives loyalty. Paper presented at the ARF Week of Workshops, New York. Retrieved from http://www.sdr consulting.com/article4.html, Accessed on March 12, 2017. 
34. Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1985). A Conceptual Model of Service Quality and Its Implications for Future Research. The Journal of Marketing, 49(4), 41-50.
35. Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple item scale measuring perceptions ofservice quality.  Journal of Retailing, 64(1), 12-40. 
36. Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1994). Reassessment of expectations as a comparison standard in measuring service quality: Implications for further research. Journal of Marketing, 58(1), 111-124. 
37. Sadek, D. M., Zainal, N. S., Taher, M. S. I. M., Yahya, A. F., Shaharudin, M. R., Noordin, N., Zakaria, Z., & Jusoff, K. (2010). Service Quality Perceptions between Cooperative and Islamic Banks of Britain. American Journal of Economics  and Business, 2(1), 1-5. 
38. Singh, A. K., & Gupta, N. (2014). Metrics for human assets: An empirical analysis of the current practice in service sector organizations in India. Amity Business Review, 15(1), 20-30. 
39. Sitzia, J. and Wood, N. (1997) Patient satisfaction: A review of issues and concepts. Social Science and Medicine, 45(12), 1829-1843. 
40. Solomon, M. B. (1999). Consumer Behaviour: A European Perspective. New Jersey: Prentice Hall Inc. 
41. Sureshchandar, G. S., Rajendran, C., & Anantharaman, R. N. (2002). The relationship between service quality and customer satisfaction–a factor specific approach. Journal of services marketing, 16(4), 363-379. 
42. The National Archives. (2013). National Health Insurance. Retrieved from http://www.nationalarchives.gov.uk/cabinetpapers/themes/national-health-insurance.htm, Accessed on March 12, 2017. 
43. Tucker, J. (2002). The moderators of patient satisfaction. Journal of Management in Medicine, 16(1), 48-66. 
44. Tucker, J. L., & Adams, S. R. (2001). Incorporating patients’ assessments of satisfaction and quality: an integrative model of patients’ evaluations of their care. Managing Service Quality: An International Journal, 11(4), 272-287. 
45. Utouh, J., & Mowo, I. (2000). Business Administration and Management. Dar es Salaam, Tanzania: Dar es Salaam NBAA. 
46. Wang, H. (2008). Comparative health systems. In Kris, H. (ed.) International Encyclopedia of Public Health. Oxford: Academic Press, pp. 799-806.
47. Williams, S. J., & Calnan, M. (1991). Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care settings. Social science & medicine, 33(6), 707-716. 
48. Woodside, A. G., Frey, L. L., & Daly, R. T. (1989). Linking service quality, customer satisfaction, and behavioral intention. Journal of health care marketing, 9(4), 5-17. 
49. Yang, Z., Peterson, R. T., &  Cai, S. (2003). Services quality dimensions of Internet retailing: an exploratory analysis. Journal of Services Marketing, 17(7), 685-700.