Background: Health institutions, particularly public hospitals, continue to be cash cows for medico-legal practitioners owing to patients not receiving services as promised. Educational institutions should not only compete on research, innovation, and graduates with a competitive edge, but also on the quality of health services provided to students. The countless service delivery protests in South Africa indicate that consumers will not tolerate poor service. Objective: To evaluate service quality and identify priority improvement areas at a university health centre. Methods: A prospective descriptive quantitative research design was used. The target population was university students visiting a university health centre in Limpopo Province. A convenient purposive sampling method was used. The SERVQUAL model, a 22-item two-factor model with five quality dimensions (Reliability, Responsiveness, Empathy, Assurance and Tangibles), was the basis for data collection. Additional questionnaire items were relative importance of the dimensions and whether services should be improved. Expectations (E) and perceptions (P) of quality responses were scored on a 5-point Likert scale. Confirmatory factor analysis (CFA) was used to test the model. Data were analysed using the gap analysis (P-E), means and standard deviations and paired t-test. The level of significance was p < 0.005. The Expectation-Service Gap Grid (ESGG) was used as an additional tool to identify priority areas. Results: Of the 96 participants, 71% were male, and 82% were aged from 18 to 25 years. Tangibles (23.3%) and Reliability (22.2%) were the most important dimensions. A negative gap (P-E) score was detected in all five dimensions of service quality: Reliability: −0.3716, Responsiveness: −0.3773, Empathy: −0.3781, Assurance: −0.4920 and Tangibles: −0.1674. Assurance had the most negative score but the second-most negative weighted gap score (−0.0882) after Reliability (−0.0825). Tangibles had the least negative gap (−0.1674) and weighted gap scores (−0.390). Reliability was the most affected dimension, and priority areas included providing services the centre claimed to have (t = −4.334, p < 0.001) at a promised time (t = −3.953, p < 0.001). There were significant differences between expectations and perceptions (p < 0.001) in 15 attributes. Majority (79%) wanted services to be improved. Conclusion: Service gaps were identified in all dimensions of service quality and majority of patients wanted services to be improved. We identified priority improvement areas using a combination of approaches (weighted gap scores, t-tests, level of significance and ESGG) to simplify the managers’ action plan and avoid wasteful and fruitless expenditure. The study will further give management direction regarding programme development and will function as a point of reference for future research.
Author Contributions
Conceptualization, A.R.S.-R.; methodology, A.R.S.-R. and P.M.; software, P.M. and A.R.S.-R.; validation, A.R.S.-R. and P.M.; formal analysis, P.M. and A.R.S.-R.; investigation, A.R.S.-R. and P.M.; resources, A.R.S.-R. and P.M.; data curation, A.R.S.-R.; writing—A.R.S.-R. and P.M. original draft preparation, A.R.S.-R. and P.M.; writing—review and editing, A.R.S.-R.; visualization, A.R.S.-R. and P.M.; supervision, A.R.S.-R.; project administration, A.R.S.-R. All authors have read and agreed to the published version of the manuscript.
Funding
This research was funded by Staff Development and Empowerment of Women Researchers Grant (for data collection only) from the Department of Education, through the University of Limpopo, grant number [Grant 2009/Cost Centre: Polokwane Campus (C130) Code 1874].
Institutional Review Board Statement
Ethical approval was obtained from Management College of South Africa Research (MANCOSA) Ethics Committee and Turfloop Research Ethics Committee (TREC). Permission to publish the study was obtained from TREC chairperson, Dr Thembinkosi Mabila. The study was conducted in accordance with the declaration of Helsinki, and approved by the Institutional Review Board (UNIVERSITY OF LIMPOPO—6 September 2013 and MANCOSA—8 November 2012).
Informed Consent Statement
Written consent was obtained from patients to publish this paper.
Data Availability Statement
The data presented in this study are available on request from the corresponding author.
Conflicts of Interest
The authors declare no conflict of interest.
| Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
