Patient Satisfaction and Perception of Community Pharmacy Services in Sidama, Ethiopia: A Mixed-Methods Study Using an Adapted SERVQUAL Framework

BackgroundCommunity pharmacies are vital for healthcare access in Ethiopias Sidama Region, yet patient satisfaction and perceptions of service quality remain understudied. This study evaluates patient satisfaction with pharmaceutical services in urban (Hawassa) and rural (Bensa, Aroresa) settings using a mixed-methods approach and an adapted SERVQUAL framework, incorporating six dimensions: reliability, responsiveness, assurance, empathy, tangibles, and accessibility. MethodsA cross-sectional survey of 400 patients and in-depth interviews with 20 participants were conducted in 2025. Quantitative data were analyzed using descriptive statistics and regression analysis, while qualitative data underwent thematic analysis. ResultsUrban patients reported higher satisfaction (M = 4.31, SD = 0.74) than rural patients (M = 3.12, SD = 0.88). Reliability ({beta} = 0.326, p < 0.001) and accessibility ({beta} = 0.244, p < 0.001) were significant predictors of satisfaction. Qualitative findings highlighted challenges such as medicine stockouts, language barriers, and gender-based discomfort, particularly in rural areas. A Sidama-specific SERVQUAL model was developed, emphasizing culturally and linguistically sensitive services. ConclusionsThe study reveals urban-rural disparities in pharmacy service satisfaction and underscores the need for targeted interventions to enhance medicine availability, cultural sensitivity, and accessibility in Sidama. The adapted SERVQUAL framework provides a robust tool for evaluating pharmacy services in similar low-resource settings.