Service Quality Management Practices and Healthcare Quality in Zambia’s First Level Hospitals: Evidence from Chilenje and Matero Hospitals

Background: Healthcare quality remains a critical concern globally, particularly in low- and middle-income countries where healthcare systems continue to face operational and resource-related challenges. This study examined the influence of service quality management practices on healthcare quality at Chilenje First Level Hospital and Matero First Level Hospital in Lusaka District, Zambia. Specifically, the study focused on patient satisfaction, communication, interpersonal care, waiting time, affordability, and patient safety as key dimensions influencing healthcare quality. 
Methods: A facility-based quantitative cross-sectional study design was employed involving 385 respondents comprising patients, healthcare workers, and hospital management personnel. Data were collected using structured questionnaires based on the SERVQUAL model and Systems Theory. Descriptive statistics, Pearson correlation, and multiple linear regression analyses were conducted using SPSS version 26. 
Results: The findings revealed that service quality management practices significantly influenced healthcare quality. Patients reported higher levels of satisfaction when healthcare workers demonstrated professionalism, empathy, responsiveness, respectful communication, and clear explanations regarding diagnoses and treatment procedures. Correlation analysis demonstrated strong positive relationships between healthcare quality and interpersonal care, communication, patient satisfaction, and patient safety. Waiting time demonstrated a significant negative relationship with healthcare quality. Regression analysis showed that interpersonal care, communication, patient satisfaction, waiting time, and patient safety significantly predicted healthcare quality (R² = 0.764, p < 0.001). 
Conclusion: The study concludes that strengthening service quality management practices, particularly communication, interpersonal care, responsiveness, and patient safety, can significantly improve healthcare quality and patient satisfaction in Zambia’s First Level Hospitals. However, persistent challenges such as overcrowding, staffing shortages, medicine stockouts, and long waiting times continue to negatively affect healthcare delivery and require urgent policy and management interventions.