Quality Assessment in Primary Healthcare Using Kano-Fuzzy-SERVQUAL: Young Women's Perspective

Abstract

This paper aimed to evaluate the quality of services provided at Primary Healthcare Units (PHUs) in Salgueiro-PE from the perspective of young adult women users, through the integration of Kano Model, Fuzzy Logic and SERVQUAL. A structured questionnaire with 23 quality attributes was applied to 109 women between November 2020 and April 2021. The results revealed an overall quality mean of 2.96 (median=3.0), indicating a median satisfaction perception. The Kano-Fuzzy analysis identified six critical attributes that demand priority attention: physical environment (Attribute 2), reliable information transmission (Attribute 6), demonstration of commitment to improvement (Attribute 9), and aspects related to empathy and safety (Attributes 11, 13, 14). The predominantly unidimensional classification of attributes suggests that incremental improvements directly impact users' satisfaction. The study contributes methodologically by integrating innovative evaluation techniques, contextually by analyzing a medium-sized municipality in the northeastern semi-arid region, and managerially by providing an evidence-based prioritization matrix for primary care managers.