الفهرس 
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Abstract
Youth is seen as the most dynamic sector of the population and the major deciding factor for the future, so society depends increasingly on this sector of the population.As a result, a special attention must be given to this significant segment of the population, as well as their needs and problems.
In fact, youth is best defined as a period of transition from childhood’s dependence to adulthood’s independence and it entails vital life transitions, such as graduating from the education system and starting a job. Moreover, it is a stage of crucial growth and development, characterized by rapid physical, psychosocial, and cognitive development, as well as sexual and reproductive maturation.
The continuous need for improved outcomes and quality of health services provided is critical in developing a more effective organizational policy that is tailored to the demands of the clients. Thus, the quality of healthcare provision may be enhanced by identifying current problems, and a crucial area for identifying such problems is the assessment of client satisfaction.
Furthermore,measuring client satisfaction gives important data on how well the provider meets clients’ expectations and provides unique and relevant insights regarding care and quality. Thus, client satisfaction and the quality of health services are key components for the long-term success of health care facilities.
This study was conducted to assess the level of youth’ satisfaction and the factors associated with level of youth’ satisfaction about health services provided at Family Health Care Centers in Alexandria.
Descriptive research design was used to conduct this study. It had been carried out in 16 family health centers in Alexandria, affiliated to the Ministry of Health, which were selected randomly namely; El-Amrawi and El-Mandara family health center affiliated to El-Montazah zone, El Hadra Qebli and El Attarin family health center affiliated to Middle zone, San Stefano and Bacos family health center affiliated to East zone, El amoud and Karmus family health center affiliated to West zone, El Amal and El Hagari family health center affiliated to Elgomrok zone, EL-ameriya and El-Wadi family health centeraffiliated to EL-Ameriya zone,El Agamy El Bahria and Eldkhila family health center affiliated to El-Agamy zone,and Borg El Arab Old Centraland Health Centeraffiliated to Borg El Arab zone. The study was conducted on 400 youth who were attending the previously selected family health centers.
Tools of study
Three tools were used in this study to collect the necessary data. The first tool was Youth’ Profile Structured Interview Schedule, including three parts;socio-demographic characteristics of youth, youth’ health profile data and youth’ life style data. The second tool was Youth’ satisfaction scale about services of family health centers.The third tool wasObservational checklist of family health centers and services. It included two parts; the organizational structure and the provided services.
Approvals were obtained for conducting the study at the specified settings. A pilot study was carried out on 40 youth representing 10% of total sample to test feasibility of the study and comprehensives of the tools.The data collection took 4 months (from the beginning of February2022 to May 2022) and then the relevant descriptive and analytical statistics were performed.
The main findings obtained from the study were as follow:
The first section included youth’ socio-demographic characteristics, health profile related data and life style related data:
Part (1):Youth’s basic characteristics.
• The mean score of the youth age was 20.22±3.419 years, while more than three quarters (79.0%) of the studied youth were females.
• More than half (53.5%) of the studied youth were single, and more than two fifths (46.5%) of them were married.
• More than two fifths (41.5%) of the studied youth were living in urban areas. While, (40.3%) of them were living in squatter areas and only 18.3% of them were living in rural areas.
• Only (6.0%) of the studied youth were illiterate or just could read and write. While, more than two fifths (42.3%) had basic education, secondary or technical education (21.5%), and university education (30.3%).
• The majority (80.5%) of the studied youth was not working, and more than half (57.0%) of them stated that their family income was sufficient.
Part (2): Youth’ health profile related data:
• More than tenth (14.3%) of the studied youth had chronic diseases, amongst them, (40.4%) of them suffered from diabetes miletus, followed by hypertension, bronchial asthma, rheumatic arthritis, and thyroid disorders (22.8%, 21.1%, 19.3% and 17.5% respectively).
• A minority (3.5%) of the studied youth with chronic diseases reported irregular follow up because of the stability of their condition as stated by all of them, and half (50.0%) of them mentioned that they had no time for follow up.
Part (3): Youth’ lifestyle related data:
• More than half (55.3%) of the studied youth consumed two meals/day, while (41.5%) of them consumed three meals/day, one meal/day (2.5%) and four meals/day (0.8%). On the other hand, (40.0%) of them stated that they consumed healthy diet.
• More than one quarter (27.0%) of the studied youth were practicing exercises, mainly, walking or running (36.1%).
• Less than half (49.8%) of the studied youth were sleeping for less than 8 hours per day with a mean of 7.64±2.502 hours.
• A minority (6.3%) of the studied youth were smokers, mainly cigarettes (96.0%) and shisha (36.0%).
• The majority (89.3%) of the studied youth were performing irregular checkup, and around half (50.7%) of them reported no time as the main causes of irregular checkup, compared to money constraints (35.0%).
The second section includes youth’s utilization of the health services at the family health centers, problems encountered during their use, and their satisfaction of the provided services.
Part (1): Utilization of the studied youth according to their utilization of the family health center and problems encountered during the utilization of services:
• The main reason for visiting the family health centers was dental care as stated by (40.7%) of the youth. While, the mean number of visits of the centers was 3.250±1.591 visits.
• Only (2.5%) of the studied youth declared have previous query about the level of satisfaction of the services provided by the health center/unit.
• More than one quarter (28.5%) of the studied youth experienced problems during their visit to the health center, mainly unavailable resources (53.5%), poor quality of services (28.9%), inappropriate staff behavior (21.9%), long waiting time (12.3%), andonly (5.3%) poor cleanliness of the center. Those problems were caused by the receptionist (32.5%), lab technician (28.9%), nurse (22.8%), and physician (18.4%).
• Less than half (42.3%) of the studied youth reported the reasons of utilization of the services in the health center were near by the house. Moreover, more than one tenth (12.0%) of them reported the affordable cost of the services and only 2.5% of them stated referral from a physician.
Part (2): Youth’ level of satisfaction about the services provided by the family health centers:
• Regarding the accessibility of the services, more than two thirds (64.8%) of the studied youth had a high level of satisfaction, while more than one third (35.3%) of them had a high level of satisfaction with respect to the continuity of care.
• In relation to the comprehensiveness of care, more than two thirds (69.8%) of the studied youth had a high level of satisfaction compared to less than three quarters (73.0%) of them who had a high level of satisfaction concerning the humanness of the staff.
• Concerning the provision of health education and counseling, more than two thirds (69.5%) of the studied youth had a high level of satisfaction, compared to 62.0% of them who were highly satisfied with the effectiveness of the health care services.
• Pertaining to the total youth’s satisfaction, less than two thirds (64.8%) of the studied youth had a high level of satisfaction, and only 7.0% of them had a low level of satisfaction.
Part (3): Correlationbetween youth satisfaction about the services provided by the family health centers and their basic characteristics:
• less than two thirds (62.1%) of the studied youth aged from 15 to less than 17 years had a high level of satisfaction compared to 64.4% of the studied youth aged from 23 to 24 years.
• A high level of satisfaction was more prevalent among females (64.9%), and married youth (65.6%). Moreover, a high level of satisfaction was more present among those who were illiterate or just could read and write (70.8%) in comparison to university education (62.8%).
• Occupation had a significant impact on the level of satisfaction of the studied youth (X2=8.379, P= 0.015), as a high level of satisfaction was more prevalent among non-working youth (68.0%) compared to working youth (51.3%).
• Less than two-thirds (60.2%) of the studied youth with a family monthly income less than 2000 pounds had a high level of satisfaction compared to monthly income more than or equal 4000 pounds (53.3%).
• High level of satisfaction was encountered less among the studied youth who have chronic diseases (57.9%). On the other hand, youth with irregular checkup (65.3%) had higher level of satisfaction in comparison to youth with regular checkup (60.5%).
Relation between the studied youth’s level of satisfaction about the services provided at the family health centers and their health care services utilization:
• A high level of satisfaction was prevalent among 72.2% of the studied youth who visited the health center in the last year from 2 less than 4 visits in comparison to 8 visits and more (27.3%).
• Statistically significant relations between level of satisfaction and both reporting problems to mangers (X2=22.063, P= 0.000) and solving such reported problems (X2=33.697, P= 0.000).
The third section includes observation of the family health centers.
Level of quality services at family health centers:
• The majority (87.5%) of the studied health centers had a high level of quality and 12.5% of them had a moderate level of quality.
• More than two thirds (68.8%) of the studied centers had a high quality level in relation to the organization structure and the rest (31.3%) of the centers had a moderate level.
• The vast majority (93.8%) of the centers had a high level of quality regarding the services domain and the rest (6.3%) had a moderate level.
• Within the organization structure domain, infrastructure had the highest mean percent score (88.73%) with a mean score of (26.62±3.263) and rules & regulations governing the center had the lowest mean percent score (64.77%) with a mean of (14.25±4.359).
• Within the service domain, pharmacy had the highest mean percent score (98.10%) with a mean of (9.810±0.403), while, radiology services had the lowest mean percent score (57.00%) with a mean of (4.560±3.366).
• With respect to the total quality services had a mean percent score of (80.58%) with a mean of (225.63±17.01).
The fourth section includes correlation between youth’s satisfaction and the family health center quality care.
• There is a statistically significant relation between the mean score of the studied youth’s satisfaction and levels of quality services where a higher mean score of youth satisfaction was noted in the health centers with good quality of services (197.02±14.150) in comparison to those centers with moderate quality (177.96±29.775).
• A statistically significant relation between mean scores of the studied youth’s satisfaction and mean score of quality services provided at the studied health centers (r=0.764, P = 0.000).
In light of the present study findings, the following recommendations could be made:
• The implementation of a targeted education campaign for the youth on the usefulness of youth health services that could improve knowledge, attitudes and uptake of primary health care services among this target group.
• More staffs should be allocated at primary healthcare facilities according to the load of work done.
• Periodic professional training and development programs for doctors and nurses, as well as technical development ofthe clinics, are required for a better performance to be maximized for the care of youth.
• Medications as well as basic diagnostic measures such as radiology services must be available at all family health centers continuously.
• In referral system, ambulance services must be integrated in order to refer the clients to hospital especially in case of emergency.
• Youthsatisfactionsurveys shouldbeconductedonan ongoingbasistoassess youth’viewsonservices theyhavereceivedatfamily health centers and facilities. These data must be used as a tool for improvement of health care.
• The implementation of public awareness campaigns about risk behaviors for youth through mass media, social media platforms such as YouTube, Facebook, Twitter, and mobile applications to enhance health-promoting behaviors among the youth and to create a supportive environment for youth to adopt healthy lifestyles.
• Create an electronic monitoring program (e.g. mobile or computer-based program) for youth to assess youth’ satisfaction about health services provided at primary health settings.
• Encourage youth’ participation in researches and programs on suggestions for improvement of health services provided at family health centers.
• Community based study about youth satisfaction with services provided at family health centers in Alexandria.