Validation of the Donabedian Model of Health Service Quality in Selected States in Nigeria

Abstract

Background: Every citizen of a nation has the basic constitutional right to quality health care. However, there is a dearth of literature on the validity and reliability of the Donabedian conceptual model of health service quality in Nigeria. Aim: The current paper focused on validating the Donabedian model of quality health service in selected states in Nigeria. Methods: This is a prospective study of 479 health workforce consisting of 204 physicians, 180 nurses, and 95 health information management officers in three geopolitical zones in Nigeria. A multistage sampling technique was used to select respondents. Data were collected through a semi-structured questionnaire with a response rate of 87%. The overall reliability test of the variables yielded α =0.938. Data gathered was analyzed descriptively for the socio-demographic characteristics and Relative Importance Index (RII) to rank the criteria according to their relative importance. Results: Findings from the study reveal that the (RII) of all the items in the study instrument exceeded the universally acceptable threshold of 0.5, indicating a high level of care in Federal Tertiary Hospitals in Nigeria with regards to structure, process, and outcomes. Conclusion: The study underscored the need for the adoption of the Donabedian model in the three other geopolitical zones in Nigeria for a generalized conclusion on the validity and reliability of the Donabedian conceptual model of health service quality. We recommended that research studies on health service quality should be anchored on Donabedian conceptual model as a way to increase awareness of the relevance of the model in improving clinical care in Nigeria.