Satisfaction Survey Form - Pwds

CONCEPT NOTE

SATISFACTION SURVEY OF PEOPLE WITH DISABILITIES

Rationale:

User (People with Impairment and Disability) satisfaction in Medical and/or Rehabilitation services is a complicated phenomenon and is quite difficult to understand.

It is again difficult to quantify user satisfaction and more difficult to predict factors that contribute to it or are affected by it

However client satisfaction remains one of the most important factors for the service providers to consider for the well-being of both.

The Aim of the Survey is to answer the question:

“How effectively does the Public Health project of Gujarat Program meet the needs of the People with Impairment and Disabilities for Medical and/or Rehabilitation services?

The target population:

The people with Impairment and Disabilities of the Public Health Project District.

Criteria:

Users of Public Health System through the ongoing Public Health Project of Government of Gujarat and Handicap International.

Overall Objectives:

To improve the medical and rehabilitation service delivery to clients in the project district.

The Objectives:

To determine the level of clients satisfaction with the Public Health Project.
To explore clients views on service development.

The service components are:

Primary Health Centre
District Civil Hospital/ Community Health Centre
District Referral Rehabilitation Centre
Social Defence Office

Process:

The feedback form will be with the district referral rehabilitation centre and Public Health team. The feedback will be taken from clients by the district referral rehabilitation centre, filed and feedback will be provided to the project implementation team by the rehab centre in Core Coordination Committee Meeting or other similar platform.

Note:

The feedback from users can be taken on a random basis.

SATISFACTION SURVEY OF PEOPLE WITH DISABILITIES

FEEDBACK FORM

Name of Person with Disability: ______

District: ______Date: ______

Please help us to be better service providers

Please use the following grading for feedback:

1 Very satisfied 2Satisfied 3 Undecided 4 Dissatisfied 5 Very dissatisfied

Part A -

Sl.No.

Question

Grading

Comments

1

How satisfied are you with the quality of services provided by Primary Health Care Centre?

Services include Vaccination, intervention, treatment, referral etc

2

How satisfied are you with the quality of services provided by DistrictCivilHospital?

Services include Certification, Surgery, Medicines, referral etc

3

How satisfied are you with the quality of services provided by District Referral Rehabilitation Centre?

Services include Therapy, Aids & Appliances, Special Education, referral etc

How satisfied are you with the quality of services provided by Social Defence Office

Services include Identity Card, Schemes & benefits etc

Part B - What was the overall impression of the client/ Person with Disability on the total service delivery system he/she went through.

Please ask the interviewee to place a mark on the line below. Remember that the left side is ‘as bad as he or she can imagine’, and the right is ‘as good as he or she can imagine’

As bad as imaginable |______As good as imaginable

Part C -Any other suggestions for Public Health Project (Service Providers) to make the availability of service better for you and for other people with disabilities?

Public Health System/ Satisfaction Survey Form/ PWD/ 070806//SM