According to this argument, public health organizations should have as an overriding aim the development of policies aimed at promoting and facilitating the manifestation of the voice phenomena by customers so that the customers do not actually give rise to the exit processes due to the occurrence of the phenomena of disservice, but express, however, Imatinib Mesylate FDA their dissatisfaction. Public health organizations must encourage the development of policies aimed at facilitating the voice, which take part in the creation of processes of communication with the customers, or boost the promotion of a bond of trust and loyalty with its own customers. The more the health organizations develop a bond of loyalty with their customers, the more unlikely they turn to other health organizations to benefit from health services due to the occurrence of cases of dissatisfaction.

The need to promote a bond of loyalty with the customers is particularly felt in the health services that, being aimed at the satisfaction of people’s health needs, have their essential component in the creation of relationships based on trust and loyalty. So as to realize this bond of loyalty, public health organizations must adopt a management focused on quality, that is, on the continuous improvement in health services provided, through the identification of customers’ needs and their satisfaction in the most effective possible way. This requires an active involvement of all human resources of the public health organization in order to attain this goal together with the promotion of a more informed, active, and aware relationship with the customers.

The adoption of a management focused on quality can be encouraged by the use of different tools. From a marketing point of view, it could be fostered by the development of a process of empowerment [22, 23], which is both internal and external.Internal empowerment is based on a process of decision-making delegation in favor of health workers and, conversely, of accountability of the obtained results. It is essential to ensure the participation and the sharing of health workers in qualitative business aims, through human resources’ policies which aim at assuring workers of their own incitement. So workers can continuously consider themselves as part of a relationship between the user and the provider which forms a chain that extends across the public health organization and ends with the final customer.

In this case, empowerment has its source in a process that activates positive conditions in the
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