The perceived role and effectiveness of patient feedback system in strengthening therapeutic relationships in rural Tanzania

Document Type



School of Nursing and Midwifery, East Africa


Introduction: Patient feedback system forms an important entry point for medical personnel and healthcare administrators to identify healthcare service delivery gaps and develop responsive interventions. This may foster patient trust consequently increasing healthcare-seeking, engagement in decision, continuity, and satisfaction. However, research on patient feedback systems in rural primary healthcare settings appears limited.

Objective The paper builds on recent research on patient-provider relationships in rural Tanzania to examine the role and effectiveness of patient feedback systems in improving therapeutic relationships.

Methods The paper examines the ndings of qualitative descriptive research in rural Tanzania that employed a human-centred design approach to co-create an intervention package for improving nurse-client relationships between January and September 2022. The study used semi-structured interviews in Swahili with purposefully selected providers, patients, and administrators to explore drivers of poor provider-patient relationships in the Shinyanga region of rural Tanzania. Interviews were concurrently translated and transcribed, then systematically coded to facilitate the development of themes using a thematic analysis approach. Findings related to patient feedback systems are used for this paper.

Findings: Most participants cited the benets of an effective Patient feedback system as reducing patients’ confusion around the complaints process, promoting patients’ positivity towards providers and hospitals, and reducing tensions between patients and providers. Suggestion boxes were the most cited Patient feedback system however, there were widespread concerns about their accessibility and effectiveness. While the providers (nurses) and administrators described suggestion boxes as widely available, they armed not receiving feedback or complaints from patients for a very long time. Contrastingly, most patients described suggestion boxes as largely unavailable and ineffective, with concerns of non-user friendliness and nonresponsiveness dominating.

Conclusion Despite their potential benets in healthcare service quality improvements, the availability, user-friendliness, and responsiveness of patient feedback systems continue to be challenging. A call is made to providers, health administrators and researchers to prioritise the patient feedback system as both a useful entry point to reducing tensions in therapeutic relationships and, a tool for improving patient service uptake, continuity with care and satisfaction.

Publication (Name of Journal)

BMC Health Services Research

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.