Research

On
Service quality and customer satisfaction in health care
industry of Bangladesh
 Course Title: Service Marketing

Course code: MKT 524

Section: 1

Submitted to:

Dr. Md. Abdul Momen

Associate Professor

Department of Business Administration

East West University

Prepared by:

Name ID
Adnan Asef 2022-3-95-060

Tasnia Islam Rimy 2021-1-95-021

Nafiza Anzum Aaima 2022-2-95-013

Faria Mehjabin 2022-3-95-009

Muhammad Anwar Hossain 2022-3-91-022
Nusrat Humaira 2022-3-95-075

Date of submission: 17th December, 2013

Table of Contents
Abstract.......................................................................................................................................................1
Acknowledgment.........................................................................................................................................2
1.0 Introduction...........................................................................................................................................3
1.1 Background of The Study:..................................................................................................................3
1.2 Research Objectives...........................................................................................................................3
1.3 Conceptual Framework......................................................................................................................3
2.0 Literature Review..................................................................................................................................5
3.0 Research Methodology..........................................................................................................................6
3.1 Research Design.................................................................................................................................7
3.1.1 Exploratory Research:.................................................................................................................7
3.1.2 Descriptive Research:.................................................................................................................7
3.2 Data Collection Method:....................................................................................................................7
3.3 Data Analyzing Method.....................................................................................................................8
4.0 Findings and Analysis.............................................................................................................................8
5.0 Recommendation................................................................................................................................12
6.0 Conclusion...........................................................................................................................................14
7.0 Questionnaire......................................................................................................................................14
8.0 Reference:...........................................................................................................................................16
Abstract
This research aims to focus on the service quality and customer satisfaction in the healthcare
industry of Bangladesh. A survey of 15 respondents has been conducted. Expert opinions and
secondary data analysis have also been used to get better insights. We analyzed the perceptions
of Service Quality, Customer Satisfaction Levels, and Expert Opinions from both primary and
secondary Data Analysis. Since the healthcare sector is so important to maintaining people's
well-being, client happiness and service quality are vital to its success. The purpose of this study
is to look into the relationship between customer happiness and service quality in Bangladesh's
healthcare system. Bangladesh has recently seen major improvements made to its healthcare
infrastructure. The theoretical framework assesses service quality across dimensions such as
reliability, responsiveness, empathy, assurance, and tangibles. Qualitative information collected
from in-depth interviews will offer an elaborate picture of the variables affecting patient
satisfaction in the healthcare setting. To identify the underlying causes of satisfaction and
dissatisfaction themes including patient-centric treatment, accessibility, affordability, and
effective communication will be investigated. To achieve the best possible patient outcomes and
promote a good healthcare environment in Bangladesh, it is becoming more and more important
to comprehend the dynamics of service quality and customer satisfaction as the healthcare
landscape changes.

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Acknowledgment
We extend our sincere gratitude to all individuals and resources that have contributed to the
successful completion of this report of the Health Care Service of Bangladesh. This endeavor
would not have been possible without the support, guidance, and collaboration of various parties.
We express our heartfelt appreciation to the doctors, patients and health care frontline employees
who provided us with their valuable comments about the health care service and the gap in our
country. Their cooperation and willingness to share information greatly enriched the depth and
quality of this study.

Special thanks to our research supervisor, Dr. Md. Abdul Momen, for his unwavering support,
valuable guidance, and constructive feedback throughout the research process. His expertise and
mentorship was instrumental in shaping the methodology, analysis, and overall academic rigor of
this report.

We are also grateful to our colleagues and peers who engaged in insightful discussions, offered
diverse perspectives, and provided a collaborative environment for the development of this
study.

Furthermore, we appreciate the academic resources, libraries, and online databases that
facilitated access to relevant literature, research methodologies, and statistical tools essential for
the successful completion of this project. Lastly, we extend our gratitude to our family and
friends for their encouragement, understanding, and patience during the course of this research.
Each of these individuals and entities has played a crucial role in shaping the outcome of this
report, and for that, we are sincerely thankful.

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1.0 Introduction
The healthcare industry is dominated by the private sector with high growth in tertiary hospitals
and diagnostics centers. As of the end of 2019, there were 255 public hospitals, 5,054 private
hospitals and clinics, and 9,529 diagnostic centers under the registration of the Directorate
General of Health Services (DGHS). Bangladesh has a good healthcare network covering both
rural and urban areas. There are 3,976 healthcare facilities in the public sector and 975 privately-
run hospitals/clinics. The healthcare-delivery system of the country compares favorably with that
of many other Asian countries. But there are some issues that consumers are facing during
service and this analysis will identify responsible issues for the country's deteriorating health
care and have some solutions to this. The healthcare industry plays a pivotal role in the overall
well-being of any society. In Bangladesh, like many other countries, healthcare services are
critical for ensuring the health and quality of life of its citizens. Service quality and customer
satisfaction in the healthcare industry are paramount because they directly impact the health and
well-being of the population. This study delves into the intricacies of service quality and
customer satisfaction in the healthcare sector of Bangladesh, employing a qualitative analysis
approach to gain a deeper understanding of these vital aspects.

1.1 Background of The Study:

Bangladesh has made significant strides in improving its healthcare services in recent years. The
government has invested in infrastructure, trained healthcare professionals, and expanded access
to healthcare. However, challenges such as overcrowding, resource constraints, and varying
service quality persist. Understanding the dynamics of service quality and customer satisfaction
is crucial for further enhancements in this sector. This study seeks to explore the experiences,
perceptions, and expectations of patients and healthcare service providers to provide insights that
can inform policy, management, and service improvements.

1.2 Research Objectives

 To identify the key factors that lead to dissatisfaction with the healthcare industry in
Bangladesh.
 To understand the reasons why people in Bangladesh move to foreign countries for
treatment.
 To assess the impact of medical tourism on the Bangladeshi healthcare system.
 To develop recommendations for improving the quality of healthcare in Bangladesh and
reducing the outflow of patients to foreign countries.

1.3 Conceptual Framework

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This research adopts a SERVQUAL-based approach to understand the factors influencing
service quality and customer satisfaction in the Bangladeshi healthcare context. The framework
builds upon the five core service quality dimensions:

1. Tangibles:
Physical facilities: Cleanliness, modernity, equipment availability, accessibility.
Staff presentation: Professionalism, courtesy, attire.
Information materials: Clarity, accuracy, comprehensiveness.

2. Reliability:
Timeliness of services: Appointment wait times, treatment delays, medication availability.
Accuracy of diagnosis and treatment: Confidence in medical expertise, adherence to protocols,
error minimization.
Fulfillment of promises: Communication of expectations, transparency in procedures, follow-up
commitments.

3. Responsiveness:
Staff availability and helpfulness: Ease of reaching doctors/nurses, promptness in addressing
concerns, proactive communication.
Patient-centered care: Individualized attention, respect for patient autonomy, adaptation to
cultural needs.
Complaint handling: Promptness, fairness, thoroughness in addressing grievances.

4. Assurance:
Qualifications and expertise of staff: Confidence in doctor’s skills, training, experience,
specialization.
Reputation and accreditation of facilities: Trust in hospital standards, quality certifications,
peer reviews.
Safety and security: Infection control protocols, patient privacy, medication management
systems.

5. Empathy:
Emotional understanding: Staff sensitivity to patient anxieties, fears, and cultural background.
Compassion and attentiveness: Active listening, emotional support, addressing non-medical
needs.
Personalized communication: Clear explanations, use of language understandable to patients,
willingness to answer questions.

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2.0 Literature Review
In the study by Sultana et al. (2014), they looked into what makes India an attractive destination
for medical tourism. They found that factors like how competitive the destination is, the quality
of services, what tourists think, and the overall cost are crucial in making medical tourism
appealing in India. The research highlights that for a place to be a successful medical tourism
spot, it needs to have both natural advantages and good competitive features, especially in
healthcare. The quality of services, especially in the medical field, turns out to be really
important. People's attitudes and how much things cost also have a big impact on whether a place
is attractive for medical tourism. The authors suggest that to keep being successful in this
competitive field, it's important for a country to invest in developing its human resources,
providing specialized education, and managing costs wisely (Sultana et al., 2014).

In a study by Nazir Ullah (2019) about Bangladeshi hospitals, it was found that how well a
hospital takes care of patients directly affects whether they stay loyal. They looked at three
private hospitals in Dhaka. The study showed that private hospitals, known for being more
personal and having better facilities, are the top choice for patients. The key things that make
patients happy and want to return are a clean and welcoming environment, good communication,
and responsiveness to their needs. This tells us that hospitals in Bangladesh must focus on
keeping things clean, communicating well, and being attentive to patients to make them happy
and loyal (Nazir Ullah, 2019).

In a study by Mohiuddin (2020), looked into how satisfied people in Bangladesh are with their
healthcare. The study talks about important issues like how cities are growing fast, more people
are getting sick in certain ways, and some medicines might not be real. It shows that there are
problems in the healthcare system, like not enough doctors, not good enough education for
doctors, and issues with making sure medicines are good. The study also talks about more people
going to other countries for medical help, which means they might not trust the doctors in
Bangladesh. The study says we really need better hospitals, more training for doctors, and better
rules for medicine. It finishes by suggesting ways to fix the problems and make healthcare better
for people in Bangladesh (Mohiuddin, 2020).

In the study by Abdul Kader Mohiuddin & Dr. M. Nasirullah (2019), they highlighted the fact
how people in Bangladesh have gradually lost their confidence in their nation’s medical structure
by mentioning crucial factors. They refer to the factors such as medical incompetence, short man
power, lack of infrastructure, low budget, lack of facilities and services are leading this
generation to move towards abroad for major medical issues. According to a WHO, Bangladesh
is the second worst ranked South Asian country in terms of doctor-patient ratio which is 5.26 out
of 10,000 people (Alam, 2019). This shows that how limited the manpower exist in medical
industry in such populous country. In terms of getting length of medical facilities, as per studies
it is mentioned that in average it takes 1.5 hour for every patient to take medical facilities which
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is another frustrating fact in Bangladesh (Begum et.al, 2015; bdnews24.com 2006,
ali.et.al,2015). Another big issue is competencies. Even though our country has a limited number
of doctors but even they are not trusted by most of the population because of their lack of
expertise. This is bound to happen due to our country’s education system. Every medical student
is instructed to get 80% practical knowledge and classes and the rest should be focused on
theoretical knowledge but it is a matter of regret that in Bangladesh, even most private medical
institution’s students don’t even get to see a patient on their fourth year as well (The Daily Star,
March 2019). As for lack of infrastructure, it is very common issue for this country to have
supply shortage for every sort of medical tools and as a result they cannot match the demand of
patients. In government hospitals specifically, patients are highly dissatisfied for their unhealthy
environment. A household survey reveal that the behavior of healthcare providers is really poor
which discourages the patients heavily to admit in government hospitals (Cockcroft et.al, 2011).
Where another study reveals that patients are highly satisfied by foreign hospitals as their
healthcare providers are really flexible in communicating (Zahid, 2019). Apart from these issues,
one major factor of dissatisfaction is the corruption of this industry in our country. Like keeping
clinically dead bodies in ICU and charging for surgery (Senior Correspondent, June 2019),
swapping of deceased child with new born babies (Nasim; 2017; The Daily Star 2016), and
manipulation of multiple data. These are just few examples of many. These are the major factors
of dissatisfaction towards Bangladeshi hospitals. It is upto us to revamp the whole industry.
Raising voice against illegal activities, making the education system up to the mark, allocating
more budget for medical facilities and creating awareness in rural areas can be big steps in order
to face this challenge.

The study by Hasin et al. (2011) investigates the perception of customer satisfaction and
healthcare service quality in Bangladesh. The research, conducted at two major hospitals,
underscores the significant challenges within the Bangladeshi healthcare system, emphasizing
issues of accessibility, accountability, and safety. Using SERVQUAL analysis, the paper
assesses overall service quality, revealing substantial gaps between customer expectations and
perceptions. The examination of customer satisfaction across five functional areas highlights the
critical importance of doctor service, where only 79% satisfaction is observed. The study further
employs hypothesis testing, linking customer satisfaction to social parameters such as income
level, age group, and education. Results indicate a strong relationship between satisfaction and
income. The overall customer satisfaction is found to be low at 74.95%, emphasizing the
sensitive nature of healthcare services. The findings underscore the urgent need for customer-
oriented improvements in Bangladesh's healthcare system, acknowledging the unique challenges
associated with gathering feedback from critically ill patients. This research contributes valuable
insights for healthcare quality enhancement in the context of Bangladesh (Hasin et al., 2011).

3.0 Research Methodology

Introduction

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This is a qualitative study as we collected data from one-to-one interviews and is more
concerned with descriptive data. In terms of objectives, this is an exploratory research study
because our objective is to provide insights and understanding about Service Quality and
Customer Satisfaction in the Healthcare Industry of Bangladesh

3.1 Research Design

3.1.1 Exploratory Research:

1. In-depth Interview: We will conduct an in-depth interview on 14-15 individuals to gain
insights about their perception about Service Quality and Customer Satisfaction in the Healthcare
Industry of Bangladesh. The individuals will be into 3 categories which are

1. Those who frequently visit doctor to large hospitals.

2. Those who visit local clinics.

3. Those who visit govt. hospital.

2. Secondary data analysis: We will go through several journals related to our research topic.

3.1.2 Descriptive Research:

We will be following the questionnaire method here to know perception of customers about
Service Quality and Customer Satisfaction in the Healthcare Industry of Bangladesh. We will
also examine the demographic and psychographic profile of the target audience.

3.2 Data Collection Method:

We will be collecting both primary and secondary data:

 Primary Data: Primary data will be collected via a questionnaire where we will collect
information from 14-15 respondents. Where 4-5 of them will be doctor and 9-10 patient.
We will use that data to draw a conclusion about our research problem after analyzing it.
 Secondary Data: We will secondary data from the journals. We will collect those journals
from the internet.

Consumers who regularly visit

hospitals or clinics to receive
Sample Respondents Selection Criterion
healthcare services.
Area Dhaka city
Sample Size 14-15

3.3 Data Analyzing Method

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We will be doing qualitative research which means that the data collected from the
questionnaires will be analyzed in a descriptive way to conclude. After collecting the data, we
will conclude the response descriptively.

4.0 Findings and Analysis

Demographic Section

1. Age
Most of the respondents are between the ages of 26-35 in terms of age.

2. Gender
The total number of respondents is 13, consisting of 9 males and 4 females. This distribution
represents 69 percentage male respondents and 31 percentage female respondents.

3. Occupation
The majority of the respondents were doctors and bankers in the occupation category, and in the
education category, most of them were graduates. The total number of respondents was 13, with
5 being doctors and 8 being from other occupations as patient. This distribution represents 33
percent of respondents as doctors and 67 percent as being patients.

4. Income level
Most people had an average salary of BDT 35,000-50,000.

5. Place of residence
Most were from Dhaka and a few were from Mymensingh and other places of Bangladesh.
Research question

1. Tangibles:

Q. How would you rate the cleanliness and attractiveness of the healthcare facilities you have
visited in Bangladesh?

Patients and Doctors Response: The responses from various respondents regarding healthcare
facilities in Bangladesh frequently point to a significant difference between government and
private hospitals in terms of cleanliness and attractiveness. The majority of respondents express a
preference for private hospitals because of their well-organized management. According to many
responders, government hospitals face cleanliness challenges mainly because of insufficient
cleaning staff in comparison to the large patient volume. Additionally, respondents also point out
that the problem of government hospitals may be made worse by underprivileged and illiterate
patients who do not prioritize cleanliness. The majority of respondents commend private

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hospitals for their high standards of cleanliness, even though they acknowledge certain
drawbacks, such as possible bribery-related corruption. Most respondents praise their cleanliness
standards and also mentioned the fact that private hospitals tend to charge higher fees compared
to government facilities. Overall, the general perception strongly leans toward a preference for
private hospitals in Bangladesh due to their better-maintained, despite the associated higher costs
for patients.

2. Reliability:
Q. How often have you had to wait longer than expected for a doctor's appointment in
Bangladesh?

Patients Response:

The general agreement among respondents concerning the amount of time it takes to get an
appointment with a doctor in Bangladesh is indicative of two major problems: a significant
imbalance in the patient-to-doctor ratio and overcrowding. Many respondents state that doctors
find it difficult to devote enough attention to each individual case due to their heavy patient load.
Also, doctors often prioritize quantity above quality of care, which results in longer than
anticipated wait times for visits. This issue continues to be exacerbated by the improper
distribution of patients between younger and senior doctors. While private hospitals may offer
shorter appointments, they may still have waiting times due to doctor delays or heavy patient
loads. However, a few participants report that scheduling appointments over the phone is simple,
indicating a more seamless experience even with possible waiting problems when they arrive.
Overall, the general consensus draws emphasis to the burden placed on Bangladesh's healthcare
system, which results in long wait times for doctor appointments because of the mismatch
between the number of patients and the number of available doctors, particularly at government
facilities.

Doctor’s Response:

The doctors' responses regarding appointment waiting times in Bangladesh reflect a common
concern about the excessive patient load relative to the number of practicing doctors in the
country. They all agree that the immense number of patients surpasses the capacity of doctors to
provide adequate time and attention to each individual. This high patient-to-doctor ratio leads to
doctors having to manage an excessive number of patients within a limited timeframe, which
causes lengthier wait times for appointments.

3. Responsiveness:
Q. How satisfied are you with how healthcare staff in Bangladesh respond to your requests and
concerns?

Patients Response:

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The satisfaction level regarding how healthcare staff in Bangladesh respond to requests and
concerns varies among respondents. Some people are happy with the skill and willingness of
frontline staff, especially nurses, noting their promptness and high-quality care in both corporate
and private hospitals. However, the majority of respondents voiced unhappiness with public
hospitals, citing things like staff attitude problems, inadequate patient answers, and small
facilities. Others point out that staff reactions are occasionally compromised due to the excessive
volume of patients and the behavior of certain individuals, which detracts from the overall
experience. A different perspective is presented by a respondent who praised the healthcare
staff's responsiveness and exceptional care in India compared to varying experiences in
Bangladesh, who appreciated the healthcare staff's responsiveness and great treatment in India in
comparison to various experiences in Bangladesh. However, the general consensus indicates to a
mixed bag of experiences, with a tendency towards satisfaction in some instances while
dissatisfaction persists due to varying factors such as hospital type, patient behavior, individual
experience, and overall healthcare system limitations.

Doctors Response:

The responses from doctor's respondents in Bangladesh highlight distinct perspectives on

patient-doctor interactions and waiting times for appointments. Some emphasize the effort
doctors and nurses put into patient care but note the tendency for patients to seek multiple
opinions, leading to confusion and non-adherence to treatment guidelines. In contrast, some
doctors suggest that experienced doctors can swiftly relate to patients' issues and initiate
treatment without requiring details.

4. Assurance:
Q. How confident are you in the knowledge and skills of the doctors and other healthcare
professionals you have seen in Bangladesh?

Patients Response:

Respondents have different views on how confident they are in the expertise and abilities of
Bangladeshi healthcare workers. Several respondents expressed substantial confidence in the
competence of Bangladeshi doctors, highlighting their extensive patient exposure, equal access
to medical literature, and the presence of Bangladeshi doctors practicing successfully abroad.
However, there's a segment expressing concern over the lack of specialized training in advanced
medical procedures, especially when it comes to surgical expertise and access to sophisticated
tools. They highlight gaps in specialized surgical training, mentioning that Bangladesh may have
a longer learning curve for specialized medical training, which could have an effect on the
degree of expertise. There are also worries that the country's healthcare systems are lagging
behind in terms of equipment and technology, which would impair doctors' capacity to provide
their best treatment. Others, however, argue that although Bangladesh has qualified medical
professionals, variations exist among individuals and institutions in terms of skills and

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efficiency. The majority opinion reflects a mixture of opinions, ranging from substantial
confidence in local doctors' capabilities to concerns about the overall medical infrastructure's
limitations, including training, technology, and specialization opportunities.

Doctors Response:

Doctors in Bangladesh have different opinions about the qualifications and experience of
healthcare workers in their nation. Some doctors are confident in the ability of the local doctors,
citing their expertise and resourcefulness in patient care, while others point out serious
shortcomings in facilities, technology, and specialized training. Overall, there is a range of
viewpoints that represent the various points of view held by Bangladesh's medical community,
from assurances about the skills of local physicians to worries about systemic constraints.

5. Empathy:
Q. How well do healthcare staff in Bangladesh understand your needs and concerns?

Patients Response:
There are differences in respondents' perceptions regarding healthcare staff's comprehension of
patients' wants and concerns in Bangladesh. Several express dissatisfactions with the healthcare
system's capacity to to handle specific patient issues, attributing this to the excessive number of
patients that doctors must see. They make the point that the staff's capacity to fully comprehend
patients' histories or problems is impacted by the volume of patients, which takes precedence
over providing adequate time and attention to each case. A lack of empathy and time spent
exploring patients' issues are further complaints made by respondents, who attribute this to the
stress of handling many cases in a short amount of time. However, others offer a more balanced
viewpoint, suggesting that while there might be constraints, many healthcare professionals
attempt to understand patients' needs and demonstrate compassion and empathy. Yet, there is a
general feeling that people would rather receive treatment abroad, particularly in nations like
India, because they believe Bangladesh lacks adequate technology and equipment and that test
results are inconsistent. The general view is that issues with time limits, number of patients, and
infrastructural limitations in the healthcare system affect the capacity of medical personnel to
fully comprehend and efficiently attend to the unique requirements and concerns of each patient.
Doctors Response:
There is diversity in the opinions expressed by doctors about how well Bangladeshi healthcare
workers comprehend the needs and concerns of their patients. Some doctors pay attention to the
variety, pointing out that varied situations and medical specializations have an impact on the
level of empathy that medical specialists can exhibit. Another respondent suggests that
Bangladeshi doctors are accessible but may not sufficiently address patient concerns due to a
perception that foreign doctors do not engage in such discussions.

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5.0 Recommendation
In Bangladesh, health service is quite behind from global standard with the several index. Every
year, lots of people go abroad (especially in India) to take proper treatment, main factor is less
reliability and trustworthiness of our treatment facilities and service quality. So, required a
comprehensive model of patient satisfaction to identify patient needs, developing standards,
designing services systems and processes, establishing employee and patient roles in service
delivery, enhancing training programs, managing demand and capacity, and delivering the
needed quality of services. To these ends, measuring service quality and satisfaction is very
important.

To summarize the overall discussion, we find out different points as below to enhance the service
quality of health sector in Bangladesh:

 First of all, ensure the accountability from both Government and

non-Government/Private Hospital. Making both sector health service more accountable to
DGHS. Also, DGHS need to be more organized to monitor and control.
 It will be better, if establishing a level of service delivery affordable by the poor through
government regulations on private clinics/hospitals.
 To make a balance in Government health sector, required decentralization of health
professional’s recruitment process – from doctors to nurses.
 A structured referral system might be established, starting with a prescription from the
Community Clinic/Community Health Worker to urban level public, private specialized
hospitals, linked with a national level health database. Investment also required to
establish the referral linkage.
 Access to quality healthcare through a digitized service delivery system included quality
assurance /monitoring of drug companies.
 Creating a National Health Service database with patients’ medical history to reduce the
need for multiple diagnostic tests.
 Increase doctor-patient counseling hours, in this particular aspect doctors can take
initiative with empathetic consideration.
 If can provide universal health insurance coverage, will enhance the service quality.
 Incentives for public doctors working in hard-to-reach areas will be act as a tool to
motivate doctors to do their best even in rural area.
 Manage private clinics and hospitals to allocate a certain percentage of free beds for the
poor, by allocating a certain percentage of their profits for serving the poor.
 Increase the monitoring level of compliance at village and district level hospitals/clinics
with DGHS’s regulations.
 Required more public health specialists, not only doctors, for better administration and
coordination.
 Use of electronic records to supplement the national health/medical database can act as
better treatment process with historical data.

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  Building strategic partnerships with NGOs and private sector for strengthening and
expanding newborn care will be a better initiative.
 Incorporate counseling, health rights and ethics in all medical, nursing and other
education curricula along with proper sensitization initiatives for the existing health
service providers.
 Strengthening Bangladesh Medical Research Council/ BSMMU’s to steward and
coordinate all health sector research.
 A comprehensive mental health service delivery plan to address the growing
psychological needs might be act as stronger health providing system in Bangladesh.
 Install and use MIS through central level for greater transparency and accountability in
the health sector may improve and stopped procrastination.
Finally, Service quality, patient satisfaction and loyalty data can be used in quality management,
thereby enabling service managers to monitor and maintain service quality. Service providers
can better understand how various dimensions and items affect overall service quality, and to
design service delivery processes efficiently. By identifying service quality strengths and
weaknesses including SWOT analysis, providers can allocate resources to services and
ultimately enhance their service quality. Our findings show the perception of tangibles,
reliability, empathy and loyalty. We examined the differences between public and private
healthcare sectors regarding service quality dimensions, patient satisfaction and loyalty. Private
hospital patients perceive healthcare service quality performance more positively compared to
public hospital patients. Private hospital patients are more satisfied and are more loyal compared
to the public hospital patients. Though Bangladesh’s private hospitals managers charge more
than their public hospital counterparts, staff ensure that quality health services are provided.
Public hospital staff fail to provide the best medical services to their patients owing to a poor
healthcare system, corruption, and duplication.

To improve healthcare service quality, patient satisfaction and loyalty, public healthcare
providers should design service standards that promote reliable consist of services and not
promise more than what they can deliver. Both public and private healthcare organizations need
to focus on the patient loyalty and their service quality perceptions. They need to fulfil patient
needs, patient satisfaction and loyalty.

Public healthcare providers need well-planned strategies to strengthen service quality that
improves their patients’ perceptions. Our findings provide insights for Bangladeshi healthcare
organization and managers in other countries, which will help to improve service quality towards
patient satisfaction and loyalty.

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6.0 Conclusion
In conclusion, the research highlights on the dynamics of service quality and customer
satisfaction in the healthcare industry of Bangladesh.

The acknowledgment section appropriately indicates the collaborative effort and contributions of
various individuals and resources. The engagement with patients, and healthcare frontline
employees, coupled with the guidance of the research supervisor, Dr. Md. Abdul Momen,
reflects a comprehensive approach to data collection. The qualitative research approach and
detailed analysis of findings provide a brief understanding of patient and doctor perspectives.
The recommendations offer a strategic roadmap for improving healthcare services in
Bangladesh, addressing accountability, decentralization, referral systems, digitization, and more.

Our research reveals complete inequality in service quality between Bangladeshi public and
private hospitals, with private institutions excelling in tangibles and reliability but falling short in
empathy and assurance. While public hospitals struggle with infrastructure and resource
constraints, private facilities capitalize on patient loyalty through superior service delivery. To
bridge this gap, Bangladesh must invest in public healthcare infrastructure, prioritize staff
training, and foster transparency to build trust and ultimately, create a healthcare system that
prioritizes service quality and patient well-being.

7.0 Questionnaire
Demographic question

1. Age
2. Gender
3. Occupation
4. Income level
5. Place of residence

Research question

1. Tangibles:
How would you rate the cleanliness and attractiveness of the healthcare facilities you
have visited in Bangladesh?

2. Reliability:
How often have you had to wait longer than expected for a doctor's appointment in
Bangladesh?

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3. Responsiveness:
How satisfied are you with how healthcare staff in Bangladesh respond to your requests
and concerns?

4. Assurance:
How confident are you in the knowledge and skills of the doctors and other healthcare
professionals you have seen in Bangladesh?

5. Empathy:
How well do healthcare staff in Bangladesh understand your needs and concerns?

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8.0 Reference:
Sultana, S., Haque, A., Momen, A., & Yasmin, F. (2014). Factors affecting the attractiveness of
medical tourism destination: An empirical study on India - Review article. Iranian Journal of
Public Health, 43(7), 867-876. PMID: 25909055; PMCID: PMC4401052.

Nazir Ullah, M. (2019). Impact of Service Quality on Patient Satisfaction and Loyalty in
Bangladeshi Hospitals. International Journal of Business and Psychology, 1(2), 89-94.

Mohiuddin, A. K. (2020). Patient satisfaction with healthcare services: Bangladesh perspective.

International Journal of Public Health Science (IJPHS), 9(1), 34–45.
https://doi.org/10.11591/ijphs.v9i1.20386

Mohiuddin, A. K. (2019). Patient satisfaction in Bangladesh: Most important but mostly

overlooked. Journal of Social Service and Welfare, 1(3), 1-10.

Hasin, M. A. A., Sarker, Sudipa, Islam, N., & Shareef, M. A. (2011). Perception of customer
satisfaction and healthcare service quality in the context of Bangladesh. International Journal for
Quality Research, 5(3), 237–244. ISSN 1800-6450 (Print), 1800-7473 (Online).

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