title: Assessment of antiretroviral treatment (ART) care service provision in Tigray Region health centers, North Ethiopia.
abstract: BACKGROUND
  Client satisfaction is a vital component and main concern intertwined with strategic decisions in service provisions. To improve efficiency of services, eliciting the opinion of users about the available services and identifying factors associated with dissatisfaction is very critical. Thus, the main objective of this study was to assess the perceived levels of clients' satisfaction with health services at ART clinic level in health centres of Tigray Region in Ethiopia.
  
  
  METHODS
  Cross sectional study was conducted from May to June 2013 in Tigray Region ART clinics. A total of 714 ART care user were included in the study using both purposive and probability sampling technique. Data was collected by using structured questionnaire and the collected data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Crude and Adjusted logistic regression analyses were carried out to identify the associated factors underlying perceived levels of clients' overall satisfaction. Finally, the results were presented with table as well as odds ratio (OR) and 95% confidence interval (CI).
  
  
  RESULTS
  A total of 714 study participants were enrolled in this study. An overall satisfaction level of 89.6% was reported by ART care service users. Higher scores of satisfaction of services provisions were reported for courtesy and respect (95.80%) followed by privacy (93.28%). On the other hand, respondents' dissatisfaction was rated 35.32% for toilet cleanliness followed by 26.19% for availability of additional drugs. As for overall satisfaction and associated factors, adjusted logistic regression analyses showed that marital status [AOR = 2.01 (95% CI: 1.11, 3.60)], educational status [AOR = 3.13 (95% CI: 1.15, 8.53)], travel distance to reach health centre [AOR = 3.59 (95% CI: 1.23, 10.50)], toilet cleanliness [AOR = 2.22 (95% CI :1.62, 6.32)], and ART drug availability [AOR = 2.60 (95% CI :1.18, 6.52)] were found to have influence on overall ART service satisfaction status.
  
  
  CONCLUSIONS
  This study revealed high level of client satisfaction rate and were associated with preventable and modifiable factors such as marital status, educational status, travel distance to reach health centre, toilet cleanliness and ART drug availability. Therefore, countermeasures such as increasing access to ART service, availing clean toilet and ART drugs may further increase client satisfaction level in the region.
authors.affiliation: Institute of Biomedical Sciences, College of Health Sciences; Mekele University, Mekelle, Ethiopia. shewayebelay@yahoo.com.
authors.forename: Shewaye Belay
authors.initials: SB
authors.lastname: Tessema
authors.affiliation: Department of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. mesafintmolla@yahoo.com.
authors.forename: Mesafint Molla
authors.initials: MM
authors.lastname: Adane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012192:Retroviridae Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents