CUSTOMERS’ PERCEPTION ON FOOD SERVICE AND WATER MICROBIOLOGY LABORATORY FROM THE NATIONAL INSTITUTE OF HYGIENICS OF LOME FROM 2012 TO 2020

The general purpose of this article is to help monitor the performance of thewater and food microbiology laboratory at National Institute of Hygienics (NIH)of Lomé. To achieve it, thework focused on analyzing trends in customers’ satisfaction from the laboratory in theperiod from 2012 to 2020. This study mainly took into account the analysis ofcustomers’ satisfaction levels with satisfaction metrics such as qualityreception facilities, the waiting time, the reliability of the results and the deadline for renderingresults;

The general purpose of this article is to help monitor the performance of thewater and food microbiology laboratory at National Institute of Hygienics (NIH)of Lomé. To achieve it, thework focused on analyzing trends in customers' satisfaction from the laboratory in theperiod from 2012 to 2020. This study mainly took into account the analysis ofcustomers' satisfaction levels with satisfaction metrics such as qualityreception facilities, the waiting time, the reliability of the results and the deadline for renderingresults; customers complaints analysis as well as analysis of customers suggestions.From the results obtained, it emerged that the majority of the laboratory's customers are satisfiedof its services. Satisfaction rates were over 86% with respect to the quality ofreception facilities, more than 89% concerning waiting time, more than 93% compared tothe reliability of the results and more than 73% for the deadline for rendering results. Claimingcustomers are over 75% cleared and all cleared claims were made within the timeframeresolution expected. Customers suggestions are taken into account through the implementation ofappropriate action plans. However, the analysis of these results has made it possible to identifyinadequacies such as the non-representativeness of the samples from the various satisfaction surveysand the unavailability of certain data which should allow a morethorough. In addition, the available data have shown that the perception of the benefits of thelaboratory by customers, is not growing. However, these data made it possible to achieveto the conclusive results which deserve to be taken into account. In short, it appears clearlythat customers' perceptions in the services of the water andfood microbiology laboratory of the NIH of Lomé, is satisfactory, even if it is not growing.

ISSN: 2320-5407
Int. J. Adv. Res. 9 (10), 879-890 880 al., 2021). This satisfaction enables the growth and retention of customers ofcompanies while increasing their turnover (Ponnaiyanet al., 2021; Siltori et al., 2021). To achieve this, the implementation of a quality approachthrough a quality management system (QMS) is intended to be the essential tool (Fekari, 2011;Georgiev et al., 2015;Almeidaet al., 2018). This quality approachallows companies to be in a continuous improvement of their performance asexplains the Deming wheel. Indeed, the Deming wheel is a cyclical approachcontinuous improvement which consists, at the end of each cycle, in questioning all theactions previously carried out in order to improve them (Berrada, 2013). Customer's perceptionconstitutes a salient element for the continuous improvement of a company's services. Itmainly takes into account the feedback from customers vis-à-vis the services that the company offersto them. These returns are made of complaints and suggestions. In most of the cases,they are collected on a continuous basis but also on an ad hoc basis through surveys ofsatisfaction (WHO, 2011). Indeed, a quality approach is a business project implementedworks to control, ensure and plan quality and improve products and services,processes, production processes, customer satisfaction and more broadly, improving theperformance ofan organization and the satisfaction of all interested parties (Dumel, 2019).
In Togo, many laboratories under the authority of the ministry of health, publichygienics and universal access to healthcare are committed to this quality approach withas a goal,obtaining national recognition. This commitment was motivated by asupport for the laboratories division of this ministry (MSHP, 2019). However,only two public and privatehealth institutions willingly committed theirlaboratories in the accreditation process with international organizations (Barry,2018). Among them is the National Institute of Hygienics (NIH) with three accredited laboratories including the water and food microbiologylaboratory, the first to be accredited since 2012by the French Accreditation Committee(COFRAC).
One thing is to be in the quality process with or without accreditation and another is tomaster the dynamic of continuous improvement (Valmohammadi etal., 2015). At thisproblematic, in addition to the virtual non-existence of data on the quality of servicesof microbiological analysis laboratories (Katawa et al., 2010). Customer perceptionbeing one of the factors of this continuous improvement, the question is whether the customers'perceptionon the food and water's microbiology laboratory is satisfactory andgrowing. The increasing performance is not necessarily linked to the accreditation status (Valmohammadi etal., 2015), which makes it possible to put forward the following hypothesis: the perception ofcustomers of the food and water's microbiology laboratory is satisfactory but notgrowing. Thus, to answer all these questions and help to make data available on the quality of service provided by structures in the quality approach, the general objective of this study is to contribute to the surveillance ofcontinuous improvement in the performance of National institute of Hygienicsfood and water's microbiology laboratory ofLomé. The specific objectives are as following: a) analyze thetrends in customer satisfaction of the food and watermicrobiology laboratoryfrom 2012 to 2020; b) assess the level of relevance in the monitoring elements of thesatisfaction retained by the laboratory.
The first section of this article is devoted to the presentation of the situation of the processquality in Togo. The following section presents the method used to collect the dataas well as the results and the discussion. The final section is devoted to the presentation of theconclusion and recommendations.

Quality approach situation in Togo
The adoption of the framework law N ° 016/2009 in Togo, in force since August 12, 2009relating toorganization of the national scheme for the harmonization of standardization and accreditation activities,certification, accreditation, metrology, the environment and the promotion ofquality, allowed strengthening the performance of the QMS of togolese national companies. This law created quality structures such as the High Authority for Qualityand the Environment (HAUQE), the Togolese Standardization Agency (ATN), theTogolese Métrologie Agency (ATOMET), the Togolese Approval Committee (COTAG) and theTogolese Agency for the Promotion of Quality (ATOPROQ). Adoption of national policy quality on November 06, 2019 comes to complete the process of setting up the scheme of thenational organization of the quality system in Togo in harmony with the quality policy of theECOWAS (Avenir-Togo, 2020).
Through these initiatives, several Togolese companies (public and private) have hadnational as well as internationally community performance recognition (UEMOA, ECOWAS)(Avenir-Togo, 2020).
In the field of microbiology, a study carried out in 2006 showed that in Togo,data on the quality of services provided by medical analysis laboratories are almostnon-existent (Katawaet al., 2010).

881
Togo, after adopting the ISO 15189 standard, has commissioned diagnostic audits totake stock of 87 laboratories in the public and faith-based sector and at all levelshealth system. These audits showed a low level of implementation of the QMS in laboratories. Thus, to correct this situation, the laboratories division initiated in 2016a new approach to qualityenhancement called the "Mentorship Program". To thefollowing the implementation of this program, 35 laboratories have managed to have anational performance recognition inNovember 2019 (MSHP, 2019).However, only two public and private public healthinstitutions have accreditedtheir laboratories by international organizations. This is the National Institute of Hygienicsand the BIASA clinic (Barry, 2018). The National Institute of Hygienics alone has threeaccredited laboratories including that of microbiology analyzes of water and foodaccreditedISO 17025: 2017 in 2012. This laboratory is the only national public laboratoryaccredited in the food sector, which therefore motivatedits choice to serve as a frameworkstudy for this research work, whose aim is to provide a solution to the lack ofdata on the quality of the services of structures in quality approach in Togo.

Material And Methods:
Study framework: water and food microbiology laboratory ofNational institute of Hygienics of Lomé.
The National Institute of Hygienicsis a state structure under the authority of the Ministry ofhealth, public hygienics and universal access to healthcare. It plays the role of central public health laboratory and its mission is to ensure better access to examinations inquality laboratory, to contribute to the hygienic quality control of food products, to the rapid detection of diseases with potential epidemic, offersservices that meet qualitystandards and increase customer's satisfaction throughan adequate response to their needs. It is mainly involved in the realization ofmedical biology analyzes, epidemiological surveillance, vaccination, trainingof students and in the control of the microbiological quality of water and food.
To ensure continuous improvement of its organization and service, the National Institute of Hygienicshas registered its laboratories in a quality approach since 2002, including the oneof the microbiology of water and food. Having first managed to get accreditationISO / IEC 17025 in 2012, among all National institute of Hygienics'laboratories, the water and food microbiology laboratoryhas set itself the quality objective of maintaining ISO / IEC accreditation17025, while remaining in a continuous improvement of services to guarantee thequality of results and constantly increase customer's satisfaction. Characteristicsmeasured within the framework of the accreditation are among others microorganisms,coliforms, thermotolerant coliforms, coagulase positive staphylococci,sulfitereducing bacteria developing under anaerobic conditions, Salmonella spp includingSalmonella typhi and Salmonellaparatyphi, Escherichia coli-ß glucuronidase positive,Enterobacteriaceae, yeasts and molds, osmophilic yeasts and moldsxerophiles (INH, 2019).

Material:-
The material consists of the customer satisfaction surveys reports for the period from2012 to 2020 as well as the customer complaints follow-up sheets from this period.

Methods:-Type and study period
This is a retrospective descriptive study carried out at the National institute of Hygienicsof Lomé's water and food microbiology laboratory during the period from November 2, 2020 to April 30, 2021, aimed at collecting qualitative and quantitative data from 2012 to 2020 on customer perceptions of the services offered by the laboratory.

Perception monitoring activities
Three perception monitoring activities were selected for this study. This involves the analysis of indicators used in satisfaction surveys, the analysis of trends in complaints and the analysis of suggestions made by customers.

Study population
The target population for the study were clients of the Food and Water Microbiology Laboratory. These are the individual and corporate clients who requested the laboratory's services from 2012 to 2020 for the microbiology analyzes of water and food.

Individual customers:
These are all individual clients who have benefited from the laboratory's services on an ad hoc basis during the period from 2012 to 2020.

Company customers:
These are all the partner companies of the laboratory for whom, the laboratory carries out a regular monthly sample collection, according to the clauses of a contract.

Data collectiontechniques and instruments
The food and water microbiology laboratory organizes a satisfaction survey every fifteen (15) months to collect feedback from users of its service. The survey takes place over a 6 weeks period. Concretely, this involves collecting and analyzing customer's expectations and perceptions in relation to the laboratory's services in order to take them into account for continuous improvement of its services as required by standard NF EN ISO / IEC 17025 (2017). To collect the data, the laboratory uses a self-administered questionnaire at the site of partner companies and at the National institute of Hygienicsfor individual customers. The quiz is made up of multiple-choice questions. However, a "suggestions" box was reserved to allow respondents to freely express their opinions. The sample size varies with each survey period. This variation is presented in Table I below.
The study therefore consisted of a documentary analysis on the one hand, and an interview with laboratory managers on the other.

Literature Review:-
We analyzed the reports available from satisfaction surveys from previous years, which enabled us to collect data on satisfaction indicators and customer's suggestions. The analysis of the deviation and complaint tracking sheets also allowed us to collect data on complaints. The satisfaction indicators varied over each survey period. We therefore retained those that were relevant and common to all survey periods.

Interview
The interviews made it possible to exchange views with the laboratory managers on the managerial management of laboratory information and subsequently to have data on the different client numbers available from 2012 to 2020.

Data processing technique
The data were entered using Excel 2016 software. This software also made it possible to plot the curves and represent the tables.

Difficulties and constraints We can retain as difficulties and constraints:
On the one hand, some difficulties and constraints were noted during this study. This concerns the partial unavailability of data from the accreditation period which did not allow full consideration of all the data to better assess the satisfaction and permanent growth in laboratory performance. Nevertheless, taking into account the available data made it possible to reach conclusive results and to formulate recommendations for better improvement.
On the other hand, it was also a question of the total unavailability of data from the pre-accreditation period which did not allow a comparative analysis of the data to better assess the evolution of the laboratory's performance during the pre-accreditation period to the post-accreditation period. Table I presents   The average number of individual customers constitutes the average number of monthlyemployees for the year.Missing data is data that is not available as in thecase of data fromthe period 2012 to 2014.

Presentation of the results of the satisfaction indicators
The satisfaction threshold adopted by the laboratory for an indicator to be satisfied is 75%.
Customer satisfaction rate in relation to the quality of reception facilities Figure 1 shows the evolution of customer's satisfaction trends with respect to facilitiesreception from 2015 to 2020. In 2015, 93% of customers surveyed by the laboratory were satisfied with the quality ofreception facilities. This satisfaction rate is a cumulative satisfaction rate thatcorresponds to a total of the percentages of the assessment items such as very satisfactory andsatisfactory. Throughout the presentation of the results, the employee satisfaction rateswill have the same explanations.In 2017, 98% of customers surveyed were also satisfied with the quality of the facilitiesreception while in 2018 and 2020 this satisfaction rate was respectively 86% and90%. Figure 2 shows the evolution of customer's satisfaction trends with respect to wait times from 2015 to 2020. In 2015 and 2017, the laboratory's customers expressed the same level of satisfactionaccording tothe waiting time which amounted to 89%. This rate has increased slightly by one percent (1%)during the years 2018 and 2020 while remaining the same. Figure 3 shows the evolution of customer's satisfaction trends as a function of thereliability of results from 2015 to 2020.  Figure 4 shows the evolution of customer's satisfaction trends compared to the Deadline for rendering results from 2015 to 2020. In 2015, the expression of customer's satisfaction in relation to the deadline for deliveringresults was 85%. In 2017 and 2018, this rate fell below the threshold for satisfaction indicators usedby the laboratory (75%). This satisfaction reached 85% in 2020. Figure 5 presents the overall customer'ssatisfaction in relation to all the satisfaction indicatorsfrom 2015 to 2020. In 2015, the level of overall customer satisfaction in relation to all the indicatorsof satisfaction was total. In 2017 and 2018, this rate fell and was limited to the thresholdsatisfaction indicators (75%). In 2020, it has seen an increase again to be at100%.

Overall customer satisfaction rate in relation to all thesatisfaction indicators
These results of the satisfaction indicators presented above relate to data for the periodfrom 2015 to 2020. The results for the period from 2012 to 2014 were not presented because thedata for this period is not available. It is the same for the results of themanagement of customer'ssuggestions. Table II presents the situation of the results of the management of customer's complaints from2012 to2020 Throughout this period from 2012 to 2020, the water andfoods microbiology laboratory of NIH recorded eleven (11) customer complaints with an overall rate ofclosed claim of 91%. All registered and settled claims were made inthe expected timeframe.

Presentation of the results of the management of customer suggestions
Forty-three (43) suggestions recorded during the period from 2012 to 2020 are distributedintable III. During these three years, and out of the forty-three suggestions made by customers, threecustomer suggestions came back identically. Table IV shows the nature of thesesuggestions and their frequency of occurrence.

Discussion:-
This part, which is devoted to the discussion of the results, presents the relevance of the elementsmonitoring retained by the National institute of Hygienics' food and water microbiology laboratory inLomé.

Customer's numbers and sample sizes
The food and water microbiology laboratory provided services during 2015,2017, 2018 and 2020 to corporate partner clients, whose staff amounted respectively to52, 61, 63 and 66. At the same time, these services are provided to individual clients whose headcount for Thesedata therefore show that there is a gap between the number of clients taken into account bythe satisfaction surveys and the statistically required staff for the surveys. So we can saythat the reliability of the results of these surveys is insufficient for statisticallyacceptable conclusions.However, the effectiveness of these investigations indicates the will of thelaboratory to improve its services and customer satisfaction (NF EN ISO / IEC 17025,2017).

Satisfaction indicators Quality of reception facilities
The food and water microbiology laboratory has not escaped the rulebychoosing as an indicator of satisfaction the quality of reception facilities whichcorresponds to the second part of the reception, to measure the satisfaction of its customers in relation to its reception facilities. The surveys for 2015, 2017, 2018 and 2020 showedsatisfaction rate of over 86% with respect to this indicator. What is far abovethe satisfaction threshold retained by the laboratory (75%).
Indeed, the reception, as an element of communication, participates in the construction of the imageof companies, since it crystallizes a visitor's first impression. The reception is at theboth the process of receiving people from outside, directing themso that they find what they came looking for and the site where the first meeting takes place between the visitor and the organization. Caring for hospitality means caring for your imagewithyour customers and retain them. It is also reducing tensions and improving the climaterelational of the organism. Hospitality is therefore a source of customer satisfaction and must thereforeremain a priority for companies (Lapeyrat, 2010).

Waiting time
The National institute of Hygienics' food and water microbiology laboratory assessed the satisfaction ofits customers in relation to waiting time using measurement levels such as: short,medium and long which correspond respectively to very satisfactory, satisfactory and notsatisfactory. Surveys for 2015, 2017, 2018 and 2020 showed rates ofmore than 89% satisfaction with this indicator; which also largely exceededthe satisfaction threshold. However, in order to better measure the waiting time in the laboratory,a survey should be carried out to assess the actual waiting time in order to better understandcustomer's perception of this indicator.
Waiting time reflects the time between the arrival of a client in the reception room and thepayment of the analysis invoice. It should be measured in minutes elapsed between the hourarrival in the reception room and the time of payment of the analysis invoice. This timeis of paramount importance for customers as a relatively short waiting timewill allow thecustomer to spend less his working time and use it to increase hisproduction.

Reliability of the results
Analysis of survey reports from 2015; 2017, 2018 and 2020 showed ratesmore than 93% satisfaction with the reliability of the results. Which therefore reflects the qualityof the work carried out by the laboratory in relation to the satisfaction threshold that it has set for itself.This parameter is measured with customers through the confidence they place in the laboratory results. This confidence is explained by the fact that the laboratory hasthe ISO /IEC 17025 accreditation that it has maintained since 2012 (Almeidaet al.,2018).

Deadline for rendering results
The surveys for 2017 and 2018 showed satisfaction rates below the threshold ofsatisfaction retained by the laboratory. This shows customer dissatisfaction withthis indicator. This dissatisfaction was also confirmed through customer's suggestions,formulated in connectionwith this indicator which have never ceased to come up with eachsatisfaction survey.
The deadline for delivering resultsreflects the time between sample collection andreceipt of the results by clients. This time is strongly influenced by the incubation time of the germs looked for insamples which goes up to seven days for some germs. Thisincubation time may be prolonged if the result obtained is inconclusive (if the cultureis not well done). The customer also, for reasons of decision-making concerning the statesanitary conditions of its product, in order to quickly sell it on the market, would have wanted this delivery timeof the results to be as short as possible. This makes it a little tricky to manage customer perception in relation to this indicator and therefore demonstrates its importance to be determined.

888
To remedy this situation of customer dissatisfaction with this indicator, thelaboratory must focus on communication with them in order to provide moreclarification on the reasons for the delays in rendering results based on the analyzes to becarry out.
Overall, the satisfaction surveys for 2015, 2017, 2018 and 2020 haveshowed customer satisfaction rates of over 75% against all indicators ofsatisfaction. This testifies the quality of the work carried out by thewater and food microbiology laboratoryof National institute of Hygienicsin a continuous improvement process inwhich it engagedhimself.
However, the non-representativeness of the samples from the various satisfaction surveysdecreases the degree of reliability of these results. In addition, the lack of data from someperiods and with respect to certain parameters, would conceal useful information whichcould allow us to better appreciate the satisfactory performance of which the laboratorymakes proof. Improving data availability with samplesstatistically sufficient will allow a better appreciation of the laboratory's performance in thefuture.
To this end, to find solutions to all these shortcomings, the laboratory must take intoaccount all the partner company customers during the satisfaction surveys and ensure that the survey can cover the majority of individual customers by extending the periodinvestigation. It must also better manage data so that from now onthe research work that will follow our own can have more reliable data to better appreciate the performance of the laboratory.

Customer's complaints
Customer's complaints, as outlined in ISO 9000 (2015), represent anyexpression of dissatisfaction addressed to an organization regarding its services, for whicha response is implicitly or explicitly expected. To improve its services in orderto meet customer's expectations, the water and food microbiology laboratoryofNational institute of Hygienicshas made the efficient management of customer's complaints one of its priorities. A management planhas been set up for this purpose and takes place according to the PC05 / 01 procedure as specified in theMAQ11: 2018 quality manual of the laboratory.
From 2012 to 2020, the laboratory recorded a total of eleven (11) customer's complaints with a91% overall rate of closed claims. Closed claims were made within the deadlineexpected resolution. This always testifies to the commitment of the laboratory in the processof continuous improvement.

Customer's suggestions
Customer's suggestions allow the laboratory to learn about customers' wishesin relation to the services they receive. A good management of customer suggestions allows the laboratory to meet their requirements which today remain in continuous growth.
During the years 2017, 2018 and 2020, a total of forty-three suggestions were made bycustomers. To take these suggestions into account, the laboratory has put in place a planaction that itcommunicates to customers. The laboratory, through an analysis of the suggestions,distinguishes two types of suggestions: relevant and irrelevant suggestions. Theplanactiontherefore allows the implementation of the relevant suggestions. Concerning theirrelevant suggestions, the laboratory communicates on these suggestions to bring thecustomers to understand and accept the non-fulfillment of these suggestions.
However, three customer's suggestions came up identically in each satisfaction survey. This shows customers' dissatisfaction with these three suggestions.The unavailability of defined action plans regarding the implementation of the suggestions hasnot allowed to analyze the different types of suggestions defined by the laboratory and to identifytheir management situation. Nevertheless, dissatisfaction with these three suggestions indicatesan insufficiency either in the implementation of the relevant suggestions or in thelevel of communication on irrelevant suggestions.
In general, the analysis of the various results from the available datacollected indicated that the performance of the water andfood microbiology laboratory has been satisfactory since its accreditation in 2012 with a downward trend between2017 and 2018 and a growth from 2018.