Background:In 2012, a Client Satisfaction Survey (CSS) baseline study was conducted and the results revealed areas that needed to be consolidated and those whose gaps needed to be filled. Since then,several interventions were implemented to fill in gaps. Therefore, to understand changes in the level of satisfaction and the impact created following theinterventionssince the baseline study, NMS conducted another wave of the Client Satisfaction Survey(CSS)in 2016. The 2016wave wasa follow-up to previous waves commissioned to help NMS assess their service delivery in terms of effectiveness and efficiency, among others. Like previous rounds, the 2016 wave set out to achieve the following objectives; i) to identify areas of service delivery that NMS clients find importantii) to rate the relative level of importance attached to each of the identified areas of service delivery iii) compare results of 2013 CSS baseline study with the 2016 results to establish the progress NMS is making towards achieving customer Satisfactioniv) to make clear recommendations to enable NMS improve or restructure and improve its service delivery mechanisms to have a reliable and efficient service delivery channel to enable it reach out to its clients