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      Determinants of client satisfaction to skilled antenatal care services at Southwest of Ethiopia: a cross-sectional facility based survey

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          Abstract

          Background

          Patient satisfaction to Antenatal care services has traditionally been linked to the quality of services given and the extent to which specific needs are met. Even though data in this area was limited in Ethiopia, improving quality of care was one of the strategies in health sector development program IV. This study, therefore, attempted to assess client satisfaction to skilled antenatal care services in the study area.

          Methods and materials

          A cross-sectional facility based survey was conducted among women who were attending antenatal care clinic, using quantitative method triangulated with qualitative data collection. Participants were selected using systematic sampling method according to the flow pregnant women to the antenatal care clinics. The study was carried out in all functional public health centers in the district. During the survey, 405 women were interviewed. A logistic regression model was applied to control for confounders.

          Results

          Out of the total respondents, overall satisfied to skilled antenatal care services were about 277(68%). The most common specific component of antenatal care that had good-satisfaction by the respondents was “Privacy” at examination (81.7%). Most satisfied health education session was “Diet and nutrition” session (82.2%). Absence of sonar test, no doctor and long waiting time were commonest causes of dissatisfaction. Respondents who have > 2 previous antenatal care visit were 3 times more likely (AOR = 2.93; 95% CI, 1.21, 7.12) to have satisfaction to antenatal care services as compared to those with < 1 visit. Women whose current visit fourth were 9 times more likely (AOR = 9.02, 95% CI; 1.76, 46.1) to be satisfied for antenatal services than those who were in the first visit. Women with family monthly income of $US 25–100 per month were 60% (AOR = 0.4, 95% CI; 0.2, 0.8) less likely to have satisfaction by skilled antenatal care services than those who had monthly household income below $US 25.

          Conclusion and recommendation

          Women who reported good-satisfaction to overall skilled antenatal care services were highest as compared to previous Ethiopian study findings. Demographic, economic, obstetric and distance factors were independent predictors of satisfaction to skilled antenatal care services. Non natives must be encouraged to seek satisfying services.

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          Most cited references24

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          Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana

          Background This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana. Methods Twenty-one individual in-depth interviews and two focus group discussions were conducted with women of reproductive age who had delivered in the past five years in the Greater Accra Region. The study investigated women's perceptions and experiences of care in terms of factors that influenced place of delivery, satisfaction with services, expectations of care and whether they would recommend services. Results One component of care which appeared to be of great importance to women was staff attitudes. This factor had considerable influence on acceptability and utilisation of services. Otherwise, a successful labour outcome and non-medical factors such as cost, perceived quality of care and proximity of services were important. Our findings indicate that women expect humane, professional and courteous treatment from health professionals and a reasonable standard of physical environment. Women will consciously change their place of delivery and recommendations to others if they experience degrading and unacceptable behaviour. Conclusion The findings suggest that inter-personal aspects of care are key to women's expectations, which in turn govern satisfaction. Service improvements which address this aspect of care are likely to have an impact on health seeking behaviour and utilisation. Our findings suggest that user-views are important and warrant further investigation. The views of providers should also be investigated to identify channels by which service improvements, taking into account women's views, could be operationalised. We also recommend that interventions to improve delivery care should not only be directed to the health professional, but also to general health system improvements.
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            Client satisfaction and quality of health care in rural Bangladesh.

            To assess user expectations and degree of client satisfaction and quality of health care provided in rural Bangladesh. A total of 1913 persons chosen by systematic random sampling were successfully interviewed immediately after having received care in government health facilities. The most powerful predictor for client satisfaction with the government services was provider behaviour, especially respect and politeness. For patients this aspect was much more important than the technical competence of the provider. Furthermore, a reduction in waiting time (on average to 30 min) was more important to clients than a prolongation of the quite short (from a medical standpoint) consultation time (on average 2 min, 22 sec), with 75% of clients being satisfied. Waiting time, which was about double at outreach services than that at fixed services, was the only element with which users of outreach services were dissatisfied. This study underscores that client satisfaction is determined by the cultural background of the people. It shows the dilemma that, though optimally care should be capable of meeting both medical and psychosocial needs, in reality care that meets all medical needs may fail to meet the client's emotional or social needs. Conversely, care that meets psychosocial needs may leave the clients medically at risk. It seems important that developing countries promoting client-oriented health services should carry out more in-depth research on the determinants of client satisfaction in the respective culture.
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              Women's satisfaction with delivery care in Nairobi's informal settlements.

              To quantify women's satisfaction with delivery care in informal settlements of Nairobi, Kenya, and to determine characteristics of women and delivery care associated with satisfaction. Household survey data analysis of 1266 women who delivered in health facilities in 2004 or 2005. Two densely populated informal settlements 7 and 12 km from Nairobi's center, where residents work primarily in the nearby industrial area or in the informal sector. Outcome Satisfaction was assessed by whether women would recommend the delivery care facility and deliver there again. Over half (56%) of women would both recommend and deliver again in the same facility. In multivariate analysis, women's satisfaction with delivery care was associated with greater provider empathy (OR = 3.68, 95% CI 2.27, 5.97). Women's satisfaction with delivery care was also associated with the pregnancy having been wanted (OR = 2.75, 95% CI 1.82, 4.14) or mistimed vs. unwanted. Women delivering at private facilities in the settlement near the industrial area were more satisfied than women delivering at private facilities in the more distant and marginalized settlement (OR = 2.12, 95% CI 1.45, 3.09). The association of women's satisfaction and provider empathy was stronger among women who experienced complications compared to those who did not. Health providers should be sensitized to the finding that unintended pregnancy is associated with lower satisfaction with delivery care. Maternal health programmes should focus on increasing provider empathy, especially for women who experience complications, in both private and government health facilities.
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                Author and article information

                Contributors
                lserawit@yahoo.com
                alasoaynalem@yahoo.com
                Fozi2014@yahoo.com
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                6 December 2018
                6 December 2018
                2018
                : 18
                : 479
                Affiliations
                [1 ]GRID grid.442844.a, Department of Nursing and Midwifery, , Arbaminch University, ; Arba Minch, Ethiopia
                [2 ]Department of Nursing and Midwifery, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
                [3 ]ISNI 0000 0001 1250 5688, GRID grid.7123.7, Department of Obstetrics and Gynecology, , Tikur Anbesa Specialized Hospital, Addis Ababa University, ; Addis Ababa, Ethiopia
                Article
                2121
                10.1186/s12884-018-2121-6
                6282368
                30522442
                1afd855d-1e8e-42ae-8493-4fd7fd1136c3
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 June 2018
                : 26 November 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Obstetrics & Gynecology
                satisfaction,skilled antenatal care,women,southwest of ethiopia
                Obstetrics & Gynecology
                satisfaction, skilled antenatal care, women, southwest of ethiopia

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