Abstract
BACKGROUND: Patient satisfaction is a key indicator of healthcare quality and an important determinant of service utilisation and adherence. In Cameroon, routine monitoring of patient experience is limited and existing evidence remains fragmented. OBJECTIVE: To assess satisfaction with health services among users of Cameroonian health facilities and identify associated factors. METHODS: A cross-sectional study was conducted from September 2022 to June 2023 in 69 health facilities across eight regions. Participants ≥ 21 years old were recruited through voluntary sampling. Satisfaction was measured using a culturally adapted PSQ-18. Descriptive analyses summarised the seven subscales. Group differences were examined using Welch’s ANOVA, and determinants of satisfaction were assessed through multivariable robust Gamma regression. RESULTS: A total of 559 participants were enrolled (median age 30 years; 76.9% women). Overall satisfaction was moderate (mean 3.49/5; 62.3/100). Communication, technical quality and interpersonal manners had the highest scores, whereas financial aspects and accessibility were the lowest. Significant disparities were found by facility type, facility category and region. In the adjusted model, satisfaction was about 10% lower in public facilities compared with private facilities (expβ = 0.90; 95% CI: 0.85–0.96). Compared with district hospitals, satisfaction was 14% higher in Regional Hospitals (expβ = 1.14; 95% CI: 1.06–1.21) and 20% higher in Integrated Health Centres (expβ = 1.20; 95% CI: 1.13–1.28). Regionally, satisfaction was 10–20% lower in Adamawa, East, Far North and Douala/Littoral compared with the Centre region. Sociodemographic variables—including age, sex, education, income, and residence—were not associated with satisfaction. CONCLUSION: Patient satisfaction in Cameroon is moderate and shaped primarily by structural and organisational factors, with substantial disparities across facility types, facility categories and regions. Targeted improvements in district-level services, financial accessibility, and public facility organisation could meaningfully enhance patient experience. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13959-0.