Gap analysis between expectations and perceptions of pregnant women attending Prevention of Maternal to Child Transmission of HIV services in a private referral hospital in northern Tanzania: A cross-sectional descriptive study

Objective Pregnant women satisfaction with the Prevention of Mother-To-Child HIV Transmission services is an essential parameter in the determination of the quality of care and performance. This study aimed to measure the gap between pregnant women expectations of PMTCT services and perceptions of the actual PMTCT services and the relationship between their service gap scores and socio-demographic characteristics. Methods A cross-sectional descriptive study design was conducted from August to September 2020 on a sample of 105 participants. A pre-tested SERVIQUAL questionnaire was used to collect data and paired sample t-test, independent one-sample t-test, and one–way ANOVA was used to compare mean service gap scores. A p-value of < 0.05 was considered statistically significant. Results The overall mean gap score was (+ 0.31) indicating pregnant women perceived value of the quality of care of PMTCT services. The gap score in the 5 service dimensions was as follows: empathy (+0.49), tangibles (+0.43), assurance (+0.22), responsiveness (+0.20), and reliability (+0.19). Marital status (p-value 0.031) was the only social demographic characteristic associated with pregnant women service gap scores. Conclusion Overall, pregnant women perceptions of PMTCT services provided in the RCH clinic at KCMC were meet. Marital status was associated with the overall pregnant women service gap scores and perceived quality of care with PMTCT services. Pregnant women who were married had small service gap scores compared to either divorced or widowed or cohabiting women.

EVALUATIONS OF SERVICE QUALITY: THE USE OF IMPORTANCE- PERFORMANCE ANALYSIS AND SERVQUAL IN A SOUTHERN TAIWAN'S HOT SPRING RESORT

Importance-performance analysis (IPA) is a convenient tool for service quality evaluation. Likewise, SERVQUAL and the model of service quality is also another useful tool for service quality evaluation. How hot spring service providers position themselves and differentiate themselves from competitors is critical to their success. In this study, both IPA and SERVQUAL and the model of service quality are used to evaluate a hot spring service provider in Taiwan for comparisons. A modified SERVQUAL questionnaire was distributed to hot spring resort customers with 300 valid responses. Results from IPA indicated the “Reliability” as the service weakness, while SERVQUAL and the model of service quality identified the “Responsiveness” as the largest service gap. Using these tools, the service providers can identify the critical factors for improvements from different perspectives. Implications of both tools for service providers and researchers were discussed.

Assessment of Integrated Child Development Services (ICDS) at Grass Root Level in an Urban Area, Raigad District, Maharashtra

Background: ICDS is an integrated program intended for Maternal and Child Care which adopts a holistic, lifecycle approach. Its main focus is on health, nutrition and education. Urban ICDS caters to the vulnerable urban slum population. Despite the program running for four decades its impact on its beneficiaries is still slow. The Anganwadi worker and helper are the grass-root functionaries running this program through Anganwadi centre. Hence this study was conducted to assess the functioning of the Anganwadi centre. Methodology: A Descriptive Cross-sectional study was conducted at all 15 urban-ICDS Anganwadi Centres of Khopoli during September-November 2019. The Anganwadi workers and helpers were interviewed regarding their sociodemographic details, knowledge and challenges perceived to run the centre. Observational Checklist designed based on guidelines and standard proforma for monitoring of the ICDS projects was used to assess infrastructure, equipment and registers. Results: Out of 14, 11(78.57%) Anganwadi workers had more than a decade experience. Indoor space of 600 sq.ft was available in 7(46.67%) centres. Toilets with running water were available in 9(60%) Anganwadi Centres and 6(40%) were linked to the school. Functional Salter’s weighing scale was available in 11(73.33%) Anganwadi centres. All 12 registers were available in 9(60%) Anganwadi centres. The utilization of services by pregnant women was the highest. Partially immunized children were present in 2(13.33%) Anganwadi centres. The service gap was highest (100%) with health check-up. Conclusions: There is a gap in the availability of infrastructure and utilization of some services. Keywords: urban ICDS, Maharashtra, Service gap.

Redesigning the psychiatry induction

AimsTo analyse the current psychiatry induction programme with regards to national guidance, local requirements, trainee and trainer feedback and implement recommendations to streamline where possible.BackgroundJunior doctors in training rotate every 4 or 6 months depending on the grade/programme group. GP and FY trainees are often new to psychiatry therefore require a comprehensive induction.Our Trust has had a three day induction for new junior doctors comprised of 1 day Corporate Induction, 1 day Electronic Records Training and 1 day Local induction.During the 3 day induction programme there is often a service gap with covering out of hours and acute services. Trainees and trainers have expressed concern regarding the service gap.We therefore embarked on a review of the induction programme to investigate whether it could be improved in content and length of time to deliver.MethodReview the regulatory bodies requirements for junior doctor induction.Gain an understanding of the trainees and trainers perspective of the induction programme.Review the items in the induction programme according to the requirements of the regulatory bodies.Tailor the induction programme for junior doctors’ needs whilst complying with the regulatory bodies requirements.ResultThe General Medical Council (GMC), British Medical Association (BMA), Gold Guide, Health Education England (HEE) and National Health Service (NHS) employment have no specific statutory and mandatory training requirements for induction.The regulatory bodies have generic standards for junior doctor induction.Induction is the responsibility of the Trust.Trainee perspective: Electronic record system, Mental Health Act (MHA) and pharmacy training were agreed as needing review in terms of its content and length.Trainees also requested extra items to be included in the induction programme to support successful transition in to their work placements.The education department met with the Digital Team, MHA Team and Pharmacy Team to develop new and more relevant course content and add in the requested items.The new induction programme was launched in December 2019 and was reduced in length from 3 to 2 and a half days. Trainee satisfaction improved as evidence by trainee feedback.ConclusionThe review was helpful in establishing the requirements for a good induction and highlighting areas for improvement.The new induction was more focussed, shorter in duration and had improved trainee feedback.The Medical Education Department will assess the changes following the December 2019 induction and continue to review its induction programme.

Spatial effect of port service coordination of Yangtze River Delta in China based on fuzzy clustering and gravitational model

With the prevalence of international trade protectionism and transformation and upgrading of domestic market structure, the contradiction between demand and competitive development port market of the Yangtze River Delta in China has become increasingly prominent. Nineteen major ports of Yangtze River Delta in China were selected, using the methods of factor analysis, fuzzy clustering, gravitational model, the spatial effects in the hinterland were calculated from three dimensions: central potential, spatial gravity and distribution convenience, and the regional coordination of port services was analyzed. The results show that the potential of Shanghai Port and Ningbo-Zhoushan Port in China is stronger, and the distribution difference is quite obvious. The spatial gravity of each port city superimposes to form an obvious dense semi-circular zone, and the participation ability of the marginal ports is weak. The distribution convenience in hinterland changes from location-dependent to traffic-dependent. The service gap in the hinterland of the port system is more significant, but the expansions of spatial effects make regional coordination gradually improve.

Measuring Hukou Amenity by Using Urban Land Price in China

This paper conducts an empirical study on the land supply with Chinese characteristics in terms of the most different characteristics between China and other major economies in the world, such as Hukou (household registration) system, by combining qualitative and quantitative analysis. The main purpose of this paper is to use land price to measure city amenity in China. By doing this, the spatial distribution of urban residents becomes much more understandable. This paper firstly points out the driving forces of population migration to cities are not only wages, but also cities’ amenity. The paper suggests that it is important to quantify the amenity of a city to understand the specific mechanism of amenity in population flow and regional development. It is found that the amenity of Hukou of other grades is far less than that of those top cities like Beijing. The paper suggests this polarization not only causes the sense of unfairness, but also damages the free flow of elements and economic efficiency. This paper has also recommended some useful thoughts on this issue, like to remove the limitation of population in the super first tier or first tier cities to give full play to the agglomeration effect and advantages of big cities. Besides, the supply of public goods cannot be too concentrated in large cities. The government needs to constantly narrow the regional public service gap on the supply side, gradually eliminate the privileges behind Hukou, and let the Hukou system return to its original meaning. JEL classification numbers: R20, R58. Keywords: Hukou, Amenity, Urban Land Supply.

Measuring Service Gap of Banking services in Bangladesh- A Study Based on Selected Private Commercial Bank in the Northern Region

This research investigates the service gap between client’s expectation and perception regarding banking services in Bangladesh with a particular focus on the SERVQUAL model along with the five dimensions: Tangibility, Reliability, Responsiveness, Assurance, and Empathy. We investigate the dimensions of quality of banking service and its impact on customer satisfaction. A self-administered and structured questionnaire use to collect data from 200 respondents of banks’ clients. The SPSS software use here for analyzing data. Different statistical tools use which are compatible with our research, such as factor analysis, reliability analysis, and hypothesis testing. We survey twenty private commercial banks. Average of ten customers take as a sample from each bank. As for clients’ perception, the services gap (Expected service - Perceived service), in the dimensions of reliability, responsiveness, and empathy, is significant because expected service is below perceived service in the private banks in the northern region of Bangladesh.