CHAPTER ONE

1. INTRODUCTION
This chapter presents the background of the study, the statement of the problem, the objectives
of the study, the research questions, the significance, and the delimitations of the study.

1.1.Background of the Study

Customer satisfaction and service quality remain critical issues in most service industries, and
are even more important for financial service providers that offer generally undifferentiated
products. For example, in the insurance industry, the major approach to differentiation and the
principal means by which one insurer can distinguish itself from another is service before and
after the sale of the policy (Stafford and Wells, 1996).

According to WHO definition, Quality of Health Care is the degree to which health services for
individuals and populations increase the likelihood of desired health outcomes.  It is based on
evidence-based professional knowledge and is critical for achieving universal health coverage.
As countries commit to achieving Health for All, it is imperative to carefully consider the
quality of care and health services. In most service industries, customer happiness and service
quality are still top priorities, and this is especially true for financial service providers who
provide items that are frequently interchangeable. For instance, in the insurance industry, the
principal means by which one insurer may distinguish itself from another is via service both
before and after the sale of the policy (Stafford and Wells, 1996).

Because of the nature of services, establishing service quality is more difficult than describing
product quality. Parasuraman et al. (1985) created a service quality measurement method
(SERVQUAL) and defined service quality as the difference between customer expectation and
perception across five dimensions. They go on to characterize consumers' perceptions of service
quality as a function of the gap between expectations about the performance of a broad class of
service providers and assessments of a specific firm within that class. The authors identify five
elements of service quality: tangibles, dependability, responsiveness, assurance, and empathy.