title: Client satisfaction with cervical cancer screening in Malawi.
abstract: BACKGROUND
  Assessing client and patient satisfaction towards a service is of programmatic importance. A study was conducted in Malawi between July and October 2013 to assess client satisfaction among women who had been screened for cervical cancer using Visual Inspection with Acetic acid test.
  
  
  METHODS
  This was a cross sectional descriptive study which was conducted in 16 out of 43 cervical cancer screening centres. A semi structured questionnaire was used for data collection. Data were analyzed using STATA version 11 for windows. Descriptive statistics were computed to summarize participant characteristics. Logistic regression was also conducted to assess the relationship between client satisfaction with the service and the independent variables.
  
  
  RESULTS
  One hundred and twenty women with a mean age of 33.7 (SD = 10.1) participated in the survey. All women reported being satisfied with the received service at the facility, with 68.33% reported to be very satisfied. All demographic characteristics such as age, marital status, level of education, with exception of distance to the nearest health facility had no statistically significant association with satisfaction at both univariate and multivariate analysis. However, previous knowledge about the cause of the disease itself, its prevention, knowledge that the disease can be cured, knowledge of clinic times, previous knowledge of the VIA screening test and the source from where they heard about cervical cancer had a statistical significant relationship with the outcome variable. Logistic regression revealed that satisfaction in this study was predicted by having an appointment before the screening with adjusted odd ratio of 5.71(95%CI: 1.75 - 18.63), having previous knowledge of the VIA test, AOR = 0.021(95% CI: 0.002-0.226) distance from the home to the health facility AOR = 0.11(95%CI: 0.02-0.65) and waiting time AOR = 0.09 with 95% CI: 0.09 - 0.83. Having an appointment had the only independent variable with a positive relationship with satisfaction.
  
  
  CONCLUSIONS
  Women were satisfied with the screening service. The study also showed several challenges in cervical cancer screening services which can be considered as areas of potential improvement.
authors.affiliation: Department of Public Health, School of Public Health and Family Medicine, University of Malawi, College of Medicine, Mahatma Gandhi Road, Private Bag 360, Chichiri, Blantyre 3, Malawi. fmaseko@medcol.mw.
authors.forename: Fresier C
authors.initials: FC
authors.lastname: Maseko
authors.forename: Maureen L
authors.initials: ML
authors.lastname: Chirwa
authors.forename: Adamson S
authors.initials: AS
authors.lastname: Muula
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016015:Logistic Models; D008295:Malawi; D008875:Middle Aged; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult