Waiting time and its impact on service acceptability and coverage at an MCH clinic in Lagos, Nigeria.

Despite efforts to reduce waiting time as a deterrent to service use informal community feedback has indicated that waiting time at Lagos Institute of Child Health (ICH) Clinic was still too long. This paper reports the results of an investigation into waiting time in relation to attendance at the clinic and also for different kinds of clinic visits. The study was carried out in February 1980 during 1 week of service operation. 562 mothers were observed. Arrival time at the services station time service was received and time of departure from the station and any relevant remarks were noted on cards given to mothers using the service. Service was defined as direct service in the form of a 1 to 1 encounter between mother/child and service personnel. Overall mean waiting time was 2 hours and 16 minutes but the range was considerable: from 3 to 278 mins. Overall mean service time was 13 mins with a range from 2 to 105 mins. The shortest waiting time (80 mins) was spent by mothers coming solely for an injection (31%). Those mothers attending food demonstration class (8%) waited the longest (over 3 hours) whereas mothers attending for the 1st time (7%) received the most service (37 mins). The 2 points at which patients collect in any number for long periods are the weighing table which also functions as the general waiting area for the clinic and the exit table where patients waiting for injection or immunization congregate. Waiting and service time increased in direct relation to the number of service stations visited. Long waiting time acts as a constraint to achieving optimum service coverage of the target community particularly as regards preventive care. To reduce waiting time it is suggested that the prompt start of service be encouraged and that a 2-shift clinic be introduced as a step towards permitting a more variable arrival time by patients.