Compassionate, Respectful and Caring (CRC) health care practice in health facilities of Bench Sheko, Kafa and Sheka zones: Patients and provider perspective

Abstract

Background Compassionate, Respectful and Caring (CRC) is a patient centered care and has paramount important to the patients. CRC is one of the four transformational agenda in Ethiopia and many efforts are done to implement CRC. However, patients experience on CRC and barriers for its provision is not well known. Objective To assess patients experience on CRC and to explore barriers for provision of CRC in the health facilities of Bench Sheko, Kafa and Sheka zones Methods This study was conducted in the public health facilities of Bench Sheko, Kafa and Sheka zones. A facility based descriptive cross-sectional study design was used. Both qualitative and quantitative approaches were employed. The quantitative component was studied on 836 patients. Furthermore, 12 in-depth interviews were conducted. For quantitative study, we applied a stratified sampling technique to select the health facilities. The final study participants (patients) were selected using systematic sampling methods. For qualitative study, we applied in-depth interview and the participants were selected purposively. Pretested structured question for quantitative and unstructured interview guide for qualitative study were used. The quantitative study was analyzed descriptively and the qualitative study results were analyzed thematically using open code version 3.6. Results A total of 820 respondents with a response rate of 98.1% were participated in this study. More than two third of clients (78%) received good CRC. Lack of medical supplies(drugs and laboratory reagents), high work load, burnout, long waiting time, low payment and poor attention by the government were practice setting related barriers. Lack of further education opportunities, absence of pre-service training and diminishing on-service trainings were education related barriers. Negative attitudes and unethical behaviors of health workers (insulting and shouting) were mentioned as health workers behavior related barriers of CRC. Unacceptable behavior of clients such as insulting, grievance, quarreling, lack of patience and high expectation were identified as clients’ behavior related barriers. According to study participants opinion, these client behaviors related barriers could be minimized if necessary medical supplies are available and health workers negative attitudes and unethical behaviors are addressed. Conclusion Provision of good CRC is relatively high. The barriers for provision of CRC were practice stetting, client behavior, educational/training and health workers behavior related. Equipping health facilities with necessary medical supplies, inclusion of CRC in the pre-service training curricula, creating educational opportunities and in-service trainings on CRC, motivating health workers through incentives and compensation packages may further improve CRC provision in SWE.