Factors Affecting Client Satisfaction with Medical Social Work Services in Public Level 5 and Level 6 Hospitals in Nairobi City County, Kenya

This study examined factors influencing client satisfaction with medical social work services in selected public Level 5 and Level 6 hospitals in Nairobi County, Kenya. Medical social workers play a critical role in addressing the emotional, psychological, and social needs of patients and their families; however, empirical evidence on client satisfaction with these services remains limited, particularly within the sub-Saharan African context. The study assessed the influence of gender, hospital service section, type of social work service accessed, and source of information on client satisfaction. A descriptive quantitative research design was adopted. Data were collected using a structured questionnaire administered to patients and relatives who accessed medical social work services in three public referral hospitals. A sample size of 377 respondents was determined using Cochran’s formula, and multi-stage sampling techniques were applied. Of the targeted sample, 364 completed questionnaires were returned, yielding a high response rate of 96.55%. The respondents comprised 188 males (51.6%) and 176 females (48.4%), indicating balanced gender representation. Data were analyzed using IBM SPSS Statistics through descriptive and inferential statistical techniques. The study was guided by Expectation Confirmation Theory, which posits that satisfaction results from the comparison between expected and actual service performance. The research instrument demonstrated high internal consistency, with a Cronbach’s alpha coefficient of 0.89.The findings indicate that overall client satisfaction with medical social work services was moderate to high. More than half of the respondents expressed satisfaction with key aspects of service delivery, including listening to client issues (56.0%), provision of adequate information (56.0%), professionalism (54.9%), knowledge and competence (57.1%), accessibility (54.9%), and overall service quality (54.9%). However, lower satisfaction levels were reported in prompt service delivery (45.1%), problem resolution (47.3%), and follow-up of client issues (47.3%), highlighting gaps in continuity of care and service responsiveness. Inferential analysis revealed that gender did not significantly influence client satisfaction (Mann–Whitney U = 16,323, p = 0.36). In contrast, hospital service section significantly influenced satisfaction (?² = 32.784, p < 0.05), with higher satisfaction reported in wards and Accident and Emergency departments, and lower satisfaction in emotionally demanding areas such as funeral home services. Satisfaction also varied significantly by type of service accessed (?² = 11.636, p < 0.05), with GBV and Child Protection services recording the highest satisfaction despite low utilization, while psychosocial counseling services recorded the lowest satisfaction. Additionally, the source of information significantly influenced satisfaction (?² = 11.413, p = 0.010), with clients referred by hospital staff reporting higher satisfaction compared to those referred by external agencies such as political or church organizations. The study concludes that while medical social work services in Nairobi County public hospitals are generally effective, targeted improvements are required in service timeliness, follow-up, and problem resolution. The study recommends strengthening case management systems, employing additional medical social workers, improving referral and information dissemination mechanisms, and enhancing Continuous Professional Development and research through the Kenya Medical Social Workers Association. These interventions are essential for improving service quality, aligning service delivery with client expectations, and enhancing overall client satisfaction within medical social work practice.