Context: Few studies in developing settings seek to determine caregivers’ level of satisfaction with medical services provided for their children. High‑quality medical care is associated with improved health outcomes and higher health‑care utilization. Aims: We sought to understand caregiver satisfaction in the pediatric ward of a large hospital in Botswana. Settings and Design: A cross‑sectional, descriptive survey was conducted in the pediatrics medical ward at a referral hospital in Gaborone, Botswana, between September and October 2017. Subjects and Methods: A cross‑sectional survey was conducted on caregivers admitted with their children in the pediatric ward of a large multispecialty hospital in Botswana. A total of 250 caregivers took a modified Service Quality Instrument from September to October 2017. The quality service instrument provides expectation and perception data in two subscales and assesses the difference between expectation and perception score, or gap score, for five dimensions of medical care. Statistical Analysis Used: All data were analyzed using Statistical Package for Social Science software. Results: The mean gap scores for the cohort were all negative, showing poor satisfaction and discrepancies between expectations and perceptions. The overall mean gap score was at − 0.315 (P < 0.001). The gap scores were as follows: for tangibles, –0.372; reliability,-0.1656;responsiveness, –0.210; assurance, −0.137; and empathy, −0.198. There was a statistically significant difference between the mean gap scores of caregivers in the oncology (−0.08) and medical cohort (−0.35) (P < 0.005). Conclusions: Caregivers in the hospital with their children were dissatisfied with the quality of care their children received in each quality domain measured. Hospital and government leaders of growing health systems have an opportunity to create environments and communication that are responsive to the needs of caregivers who are partners in the care of children.

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