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Ezo E, Getachew H, Degefu S, Ashager K. Maternal satisfaction on delivery service and associated factors among mothers delivered at Arba Minch town governmental health facilities, South Ethiopia: A cross-sectional study. SAGE Open Med 2024; 12:20503121241247995. [PMID: 38725925 PMCID: PMC11080769 DOI: 10.1177/20503121241247995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
Objective To assess maternal satisfaction with delivery service and associated factors among mothers delivered at Arba Minch town governmental health facilities, South Ethiopia, 2022. Methods A facility-based cross-sectional design study was conducted from 1 April to 30 June 2022. The total sample size was 320. A systematic random sampling technique was used to select mothers. Data were entered using Epi-data Version 3.1 and exported to SPSS Version 25 for analysis. Multicollinearity was considered using a variance inflation factor. The goodness of fit test was done using the Hosmer-Lemeshow model. Binary logistic regression was done, and variables with a p-value of <0.25 in the bivariable analysis were taken into the multivariable analysis. Statistically significant was declared at a p-value of <0.05 with an adjusted odds ratio and 95% confidence interval. Result The maternal satisfaction with delivery service was 75.0% (95% CI: 70.3%-79.4%). Being urban residence (AOR: 4.15, 95% CI: 1.87-9.19), absence of anemia during pregnancy (AOR: 2.38, 95% CI: 1.07-5.29), absence of antepartum hemorrhage (AOR: 2.96, 95% CI: 1.35-6.50), induction to onset labor (AOR: 0.08, 95% CI: 0.02-0.39), female sex of the newborn (AOR: 0.33, 95% CI: 0.15-0.72), absence of fetal distress during labor (AOR: 5.01, 95% CI: 1.69-14.86), absence of intrauterine meconium release (AOR: 2.77, 95% CI: 1.02-7.63), and presence of privacy measures during examination (AOR: 3.11, 95% CI: 1.37-7.04) were associated with maternal satisfaction. Conclusion and recommendation About 8 in 10 mothers are satisfied with the delivery service. Residence, anemia during pregnancy, antepartum hemorrhage, the onset of labor, sex of the newborn, fetal distress during labor, intrauterine meconium release, and privacy measures during examination are associated with maternal satisfaction with delivery services. Therefore, preventing anemia during pregnancy and antepartum hemorrhage, minimizing induction of labor, preventing fetal distress and intrauterine meconium release during labor, and taking privacy measures during examination might enhance maternal satisfaction with delivery services.
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Affiliation(s)
- Elias Ezo
- Department of Comprehensive Nursing, College of Medicine Health Sciences, Wachemo University, Hossana, SNNPR, Ethiopia
| | | | - Sindu Degefu
- Department of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia
| | - Kidist Ashager
- Department of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia
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Oyugi B, Audi-Poquillon Z, Kendall S, Peckham S. Examining the quality of care across the continuum of maternal care (antenatal, perinatal and postnatal care) under the expanded free maternity policy (Linda Mama Policy) in Kenya: a mixed-methods study. BMJ Open 2024; 14:e082011. [PMID: 38697765 PMCID: PMC11086406 DOI: 10.1136/bmjopen-2023-082011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/09/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Kenya still faces the challenge of mothers and neonates dying from preventable pregnancy-related complications. The free maternity policy (FMP), implemented in 2013 and expanded in 2017 (Linda Mama Policy (LMP)), sought to address this challenge. This study examines the quality of care (QoC) across the continuum of maternal care under the LMP in Kenya. METHODS We conducted a convergent parallel mixed-methods study across multiple levels of the Kenyan health system, involving key informant interviews with national stakeholders (n=15), in-depth interviews with county officials and healthcare workers (HCWs) (n=21), exit interview survey with mothers (n=553) who utilised the LMP delivery services, and focus group discussions (n=9) with mothers who returned for postnatal visits (at 6, 10 and 14 weeks). Quantitative data were analysed descriptively, while qualitative data were analysed thematically. All the data were triangulated at the analysis and discussion stage using a framework approach guided by the QoC for maternal and newborns. RESULTS The results showed that the expanded FMP enhanced maternal care access: geographical, financial and service utilisation. However, the facilities and HCWs bore the brunt of the increased workload and burnout. There was a longer waiting time for the initial visit by the pregnant women because of the enhanced antenatal care package of the LMP. The availability and standards of equipment, supplies and infrastructure still posed challenges. Nurses were multitasking and motivated despite the human resources challenge. Mothers were happy to have received care information; however, there were challenges regarding respect and dignity they received (inadequate food, over-crowding, bed-sharing and lack of privacy), and they experienced physical, verbal and emotional abuse and a lack of attention/care. CONCLUSIONS Addressing the negative aspects of QoC while strengthening the positives is necessary to achieve the Universal Health Coverage goals through better quality service for every woman.
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Affiliation(s)
- Boniface Oyugi
- Western Heights, The Mint Nairobi, M and E Advisory Group, Nairobi, Kenya
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Zilper Audi-Poquillon
- Department of Health Policy, The London School of Economics and Political Science, London, UK
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Stephen Peckham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
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Utalo D, Israel E, Lenjebo TL, Aynalem A, Darebo TD. Determinants of respectful maternity care among women who gave childbirth in Southern Ethiopia. BMC Health Serv Res 2024; 24:451. [PMID: 38600494 PMCID: PMC11007911 DOI: 10.1186/s12913-024-10813-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/01/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Having a good provision of respectful maternity care (RMC) to a woman who gives childbirth is a crucial component of maternal health care to result in positive maternal and neonatal outcomes. Disrespect and lack of women-centered care in birth discourage a woman from seeking healthcare during childbirth contributing to poor healthcare-seeking behaviour and dissatisfaction with the maternity service. The current study aimed to assess key determinants of RMC during childbirth at selected public health facilities of the Gofa zone, Southern Ethiopia. METHODS A cross-sectional study design was conducted from March to April 2021 among 390 women who gave birth in eight randomly selected public health facilities of Gofa zone, Southern Ethiopia. The level of RMC was measured using structured exit interview items. A structured-interviewer-administered questionnaire was used to collect data and then entered into Epi-data version 4.6 and exported to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were used to identify determinants of RMC among women. RESULTS A total of 390 women responded to the exit interview making a response rate of 100%. The mean (± SD) age of the 390 women was 27.9 (± 4.85) years. The overall prevalence of women who received RMC was 40.5%, 95% CI (36-45%). Two hundred and ninety-seven (76.2%; n = 297/390) women had antenatal care (ANC) attendance in the index pregnancy. A woman who had planned pregnancy (AOR = 1.72, CI: 1.04, 2.85), planned to deliver in a health facility (AOR = 1.68, CI: 1.00, 2.81), presence of familial support (AOR = 2.04, CI: 1.20, 3.48), and had information about service availability (AOR = 4.44, CI: 2.09, 9.42) were associated with RMC among women. CONCLUSION The provision of respectful maternity care in the study area was low when compared with local studies. Planned pregnancy, plan to deliver in a health facility, family support, and presence of information about service availability were factors associated with RMC among women. More attention should be given to training and supportive supervision of health care professionals on respectful maternity care and its standards to increase service uptake and make service more women-centred.
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Affiliation(s)
- Dawit Utalo
- Departement of Public Health, Consortium Project at Women Empowerment-Amref Health Africa, Wolaita Sodo, Ethiopia
| | - Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Tsegaye Lolaso Lenjebo
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amdehiwot Aynalem
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Tadele Dana Darebo
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Alemu EM, Kaso AW, Obsie GW, Fessaha HZ, Agero G. Maternal satisfaction with delivery service and associated factors among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia. BMC Womens Health 2024; 24:227. [PMID: 38589846 PMCID: PMC11000373 DOI: 10.1186/s12905-024-03069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Maternal satisfaction during delivery services is considered an important indicator of the quality of healthcare in a hospital setting and determines the uptake of services during subsequent pregnancies. However, there is limited information on the magnitude of women's satisfaction during delivery services in the study area. Thus, this study aimed to assess factors associated with maternal satisfaction with delivery services among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia. METHOD A facility-based cross-sectional study was conducted at public hospitals in Guji Zone from December 1, 2020, to January 30, 2021. Two hundred forty-nine women who gave birth at public hospitals were recruited by a systematic random sampling technique. The collected data were entered into the Epi Info 7 software and then exported to SPSS Version 26 for analysis. A logistic regression model was employed to identify the association between independent variables and maternal satisfaction during delivery services. A P-value less than 0.05 and an Adjusted Odds Ratio with 95% CI was computed to determine the strength of the association between these variables. RESULT In this study, 138(55.4%), 95% CI (49.1-61.7) women were satisfied with delivery. Mothers who delivered through cesarean section (AOR = 2.92, 95% CI: 1.34-6.33), privacy assured (AOR = 3.14, 95% CI: 1.76-5.59), shorter duration of labor (AOR = 2.82, 95% CI: 1.64-4.62), waiting time ≤ 30 min (AOR = 5.15,95% CI:1.99-13.32) and normal fetal outcome (AOR = 2.63, 95% CI:1.42-4.85) were associated with mothers satisfaction with delivery care services. CONCLUSION The overall magnitude of women's satisfaction with delivery services is low, which is below the national client satisfaction target of ≥ 85%. Factors such as mode of delivery, assured privacy, short duration of labor, waiting time ≤ 30 min, and good fetal outcome were significantly associated with women's satisfaction with delivery services. Therefore, healthcare providers should provide better management during intrapartum childbirth or emergency obstetric care to improve fetal outcomes during delivery services. In addition, health facility managers should avail infrastructure that helps to maintain the privacy of women who give birth in the facility.
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Affiliation(s)
- Endale Megersa Alemu
- Department of Family Health Services, Guji Zone Health Office, Negelle Borena, Ethiopia
| | - Abdene Weya Kaso
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia.
| | - Girma Worku Obsie
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
| | - Hiwot Zelalem Fessaha
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
| | - Gebi Agero
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
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Debelle S, Gamachu M, Deressa A, Debella A, Eyeberu A, Ayana GM, Birhanu A, Zakaria HF, Reshid F, Assefa N, Mussa I. Two out of every three pregnant women who gave birth in public health facilities of Tullo Woreda were dissatisfied with deliveries services, Eastern Ethiopia. SAGE Open Med 2024; 12:20503121241233214. [PMID: 38456162 PMCID: PMC10919126 DOI: 10.1177/20503121241233214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024] Open
Abstract
Background The level of maternal satisfaction with delivery services significantly affects health service utilization among women. Ethiopia's healthcare system and health facilities' quality have not much improved, which may contribute to women's generally poor levels of satisfaction and there was a limited study about client satisfaction on delivery services in the study area. Thus, the purpose of this study was to assess level of maternal satisfaction with delivery service and its associated factors among women who gave birth in Tullo Woreda public health facilities, Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted from 1 to 30 September 2020 among 355 women who gave birth in Tullo Woreda public health facilities, Eastern Ethiopia Data were collected using a pretested structured questionnaire through a face-to-face interview and entered into Epidata version 3.1 and analyzed using statistical package for the social sciences (SPSS) version 25. The prevalence was reported using a 95% confidence interval and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at a p-value of <0.05. Results The overall satisfaction of mothers on delivery service was 33.5% (95% CI: 27.81, 39.13). Factors such as having no antenatal care (ANC) for the index pregnancy (AOR = 0.33; 95% CI: 0.19, 0.56), women who came to health centers on foot (AOR = 0.17; CI: 0.04, 0.74) and by auto-rickshaw (AOR = 0.16; 95 % CI: 0.04, 0.64), mothers who did not satisfied with toilet service at the delivery room (AOR = 0.49; 95% CI: 0.12, 0.86) and who were not satisfied with maternal drugs availability (AOR = 0.65; 95% CI: 0.11, 0.95) were predictors of maternal satisfaction. Conclusions This study pointed out that only 33.5% of women were satisfied with delivery care services provided in public health facilities of the study area. Factors such as not having ANC, using foot and auto-rickshaw as means of transportation, availability of drugs, and toilets were predictor of maternal satisfactions. Awareness creation for the benefit of ANC follow-up and delivery in the health facilities and providing safe transportation during referral time may help mothers get a timely healthcare service, which may increase client satisfaction. The concerned entities must pay attention in timely availability of drugs and improving the toiles, which play a role in shaping and molding level of satisfaction of women.
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Affiliation(s)
- Shasho Debelle
- Tullo Woreda Health Office, West Hararge, Oromia Region, Bollo, Ethiopia
| | - Mulugeta Gamachu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Public Health, Rift Valley University, Harar, Ethiopia
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hamdi Fekredin Zakaria
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fenan Reshid
- Aweday Sub-City Health Office, Oromia Region, Aweday, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ibsa Mussa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Zewudu L, Keshaun F, Silesh M, Tefera M, Ketema Bogale E, Demis A, Tekle ZY. Preference of cesarean delivery and its associated factors among pregnant women attending ante natal care at public health facilities of Debrebrehan City, Ethiopia: Cross-sectional study. PLoS One 2024; 19:e0296990. [PMID: 38295110 PMCID: PMC10829985 DOI: 10.1371/journal.pone.0296990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/24/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND A Caesarean section is a surgical procedure used to prevent or treat life-threatening maternal or fetal complications. Women's delivery preferences have become a global issue of interest to many researchers and clinicians, especially given the ever-increasing rate of cesarean sections. There is limited data on the preference for cesarean delivery and its associated factors for Ethiopian women, particularly in the study area. The aim of the study is to assess the preference for cesarean delivery and its associated factors among pregnant women attending antenatal care at public health facilities in Debre Berhan, Ethiopia, in 2023. METHODS An institution-based cross-sectional study design was done from May 5-20, 2023, among 512 participants, and a multi-stage sampling technique was used. The data were collected by using interviewer-administered semi-structured questionnaires. The data were entered by Epi Data version 4.6 and then transferred to SPSS version 25 for analysis. With logistic regression, those variables with a p-value <0.25 in the bivariate analysis were candidates for multivariate logistic regression, and variables with a p-value <0.05 were considered statistically significant. RESULT The preference for a cesarean section was 26%, with a CI of 22.3% to 29.9%. Pregnant mothers who were not satisfied with their previous intrapartum care (AOR; 6.3 CI = (3.5-11), P = 0.01), had no knowledge about cesarean delivery (AOR; 2.9; 95% CI = 1.6-5.3), P = 0.01), had a previous history of spontaneous abortion (AOR; 3.1; 95% CI = (1.5-6.3), P = 0.001), lived in an urban area (AOR; 1.9; 95% CI = (1.0-3.5), P = 0.038), and had a current pregnancy-related problem (AOR; 4.8; 95% CI = 1.9-10), P = 0.001) were significantly associated with the preference for cesarean delivery. CONCLUSION In this study, the preference for cesarean delivery was high as compared to the World Health Organization recommendation. Pregnant mothers who were not satisfied with their previous intrapartum care, had no knowledge about cesarean delivery, had a previous history of spontaneous abortion, had an urban residence, and had a current pregnancy-related problem were significantly associated with a preference for caesarean delivery. Clinicians who are working in the delivery room should improve their service provision by using patient-centered care to increase patient satisfaction.
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Affiliation(s)
- Lemlem Zewudu
- Debre Berhan compressive specialized Hospital Amhara Region, Debre Berhan, Ethiopia
| | - Fetene Keshaun
- Department of Midwifery School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mulualem Silesh
- Department of Midwifery School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mitiku Tefera
- Department of Midwifery School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Eyob Ketema Bogale
- Health Promotion and Behavioral Sciences Department, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Aberham Demis
- Department of Midwifery, Deber-Berehan Health Science College, Debre Berhan, Amhara, Ethiopia
| | - Zewedie Yeshaw Tekle
- Department of Midwifery, Deber-Berehan Health Center, Debre Berhan, Amhara, Ethiopia
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Braimah A, Aninanya GA, Senu E. Proportion and factors influencing client satisfaction with delivery services in health facilities in the Sissala East Municipality, Ghana: A cross‐sectional study. Health Sci Rep 2023; 6:e1166. [PMID: 37008814 PMCID: PMC10055499 DOI: 10.1002/hsr2.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
Background and Aims Client satisfaction is the difference between the healthcare services delivered and the needs of the client. Anecdotal evidence suggests the quality of maternal health and delivery services in Ghana especially in the Upper West Region is appalling. Moreover, there is a paucity of data on clients' satisfaction with maternal and delivery services rendered by healthcare. This study, therefore, assessed clients' satisfaction with delivery services and their associated factors. Methods This analytical cross‐sectional study included 431 women who had delivered in the last 7 days from four health facilities within Sissala East Municipality using a multistage and simple random sampling technique. A well‐structured questionnaire was used to collect sociodemographic and client satisfaction data. All statistical analyses were done using Statistical Package for Social Sciences Version 26.0 and GraphPad Prism Version 8.0. A p < 0.05 was considered statistically significant. Results Clients’ satisfaction with general delivery services was rated as 80.3% and was significantly associated with process‐related factors (p < 0.0001) and structural‐related factors (p < 0.0001) of the health facilities. This study found that health facilities' delivery services differed significantly and were associated with clients’ satisfaction (p < 0.0001). Moreover, age group (p = 0.0200), occupation (p = 0.0090), kind of delivery (p = 0.0050), and delivery outcome (p < 0.0001) were significantly associated with client satisfaction with delivery services. Conclusion More than two‐thirds of women are satisfied with delivery services within selected health facilities in the Sissala East municipality, although satisfaction within health facilities differs. Furthermore, age group, occupation, kind of delivery, delivery outcome, process, and structural‐related factors significantly contribute to client satisfaction with delivery services. To provide more comprehensive coverage of customers' satisfaction with delivery services in the municipality, strategies such as free maternal health initiatives and health education on the significance of facility delivery should be reinforced.
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Affiliation(s)
- Alijata Braimah
- Department of MidwiferyMidwifery Training CollegeTumuUpper West RegionGhana
| | - Gifty A. Aninanya
- Department of Health Services Policy, Planning, Management and Health Economics, School of Public HealthUniversity for Development StudiesTamaleNorthern RegionGhana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
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Kidane A, Getachew T, Mesfin F, Eyeberu A, Dheresa M. Maternal satisfaction on delivery care services and associated factors at public hospitals in eastern Ethiopia. Int Health 2023; 15:189-197. [PMID: 35668629 PMCID: PMC9977211 DOI: 10.1093/inthealth/ihac038] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 05/13/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Maternal healthcare services satisfaction has been widely recognized as a critical indicator of quality in healthcare systems. Thus this study aimed to assess maternal satisfaction with delivery care services. METHODS An institutional-based cross-sectional study design was utilized among 400 randomly selected postnatal mothers from 1 to 30 February 2018. The data were entered into EpiData version 4.2.0 and computed using SPSS version 20. Bivariate and multivariate analyses were done using binary logistic regression to identify associations of factors. RESULTS A total of 400 participants were included, with a response rate of 98.8%. The overall delivery services satisfaction level of mothers was 80% (95% confidence interval [CI] 75.8 to 84.0). Delivery through caesarean section (adjusted odds ratio [AOR] 2.85 [95% CI 1.21 to 6.72]), privacy assured (AOR 3.73 [95% CI 1.79 to 7.75]), duration of labour (AOR 3.03 [95% CI 1.50 to 6.14]), waiting time (AOR 4.31 [95% CI 2.24 to 8.29]) and foetal outcome (AOR 4.33 [95% CI 1.94 to 9.66]) were associated with satisfaction with delivery care services. CONCLUSION The study revealed that four-fifths of mothers were satisfied with the delivery care services provided in public hospitals. Much effort is needed from hospital administrators and health professionals to improve delivery services satisfaction by minimizing waiting time, maintaining privacy and securing waiting areas.
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Affiliation(s)
- Addisalem Kidane
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firehiwot Mesfin
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Tafere TZ, Aschalew AY, Tsehay CT, Gebremedhin T. Process Evaluation of Facility Delivery Services in Northwest Ethiopia: In the Case of Public Health Centers. Int J Womens Health 2023; 15:235-253. [PMID: 36816457 PMCID: PMC9936882 DOI: 10.2147/ijwh.s388153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
Background Even if giving birth at health facility is vital for both the mothers and their newborns, the coverage of institutional delivery in Ethiopia is very low (50%). In that regard, several studies have shown the possible factors of low delivery service uptake from the patients' side, but evidences on delivery services at the health centers are meagre. This study aimed to evaluate the process of delivery services in public health centers of northwest Ethiopia. Methods A case study evaluation design with an embedded mixed-method was used to evaluate institutional delivery in public health centers of Gondar city. Dimensions from the access (availability, accommodation, and acceptability) and implementation fidelity (compliance) frameworks were used. A total of 363 mothers, 32 document reviews, 32 direct observations, and 17 key informants were included. The qualitative data were transcribed, translated, coded, and analysed using a thematic analysis approach. The overall process of institutional delivery services was measured based on pre-determined judgmental criteria. Results The overall facility delivery process was 75.1%, judged by availability (78.5%), compliance (70.6%), accommodation (68.8%), and acceptability (80.2%) of services. Essential medicines in some of the health centers were stockout, insufficient delivery rooms and inadequate training of health workers on obstetric and newborn care were observed. Using partograph and examining vulval-perineal region for possible laceration during intrapartum period were less practiced. Residence (AOR: 0.13, 95% CI: 0.06-0.30), ANC 1 to 3 visits (AOR: 2.65, 95% CI: 1.05-6.74) and ANC4+ (AOR: 5.57, 95% CI: 2.09, 14.84) were factors affected acceptability of delivery services. Conclusion Major constraints were in the accommodation of delivery services which needs a holistic effort from all stakeholders. Therefore, implementors with other stakeholders shall improve delivery rooms, facilitate training, and provide parenteral drugs as part of the obstetric and newborn care to improve the facility delivery services in Ethiopia.
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Affiliation(s)
- Tesfahun Zemene Tafere
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Tesfahun Zemene Tafere, Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia, Email
| | - Andualem Yalew Aschalew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chalie Tadie Tsehay
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaye Gebremedhin
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bohren MA, Hazfiarini A, Vazquez Corona M, Colomar M, De Mucio B, Tunçalp Ö, Portela A. From global recommendations to (in)action: A scoping review of the coverage of companion of choice for women during labour and birth. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001476. [PMID: 36963069 PMCID: PMC10021298 DOI: 10.1371/journal.pgph.0001476] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023]
Abstract
Women greatly value and benefit from the presence of someone they trust to support them throughout labour and childbirth ('labour companion of choice'). Labour companionship improves maternal and perinatal outcomes, including enhancing physiological labour and birth experiences. Despite clear benefits, implementation is slow. We conducted a scoping review to assess coverage and models of labour companionship, including quantitative studies reporting coverage of labour companionship in any level health facility globally. We searched MEDLINE, CINAHL, and Global Health from 1 January 2010-14 December 2021. We extracted data on study design, labour companionship coverage, timing and type of companions allowed, and recoded data into categories for comparison across studies. We included data from a maternal health sentinel network of hospitals in Latin America, using descriptive statistics to assess coverage among 120,581 women giving birth in these sites from April 2018-April 2022. In the scoping review, we included 77 studies from 27 countries. There was wide variation in the coverage of labour companionship: almost one-third of studies reported coverage less than 40%, and one-third of studies reported coverage between 40-80%. Husbands or partners were the most frequent companion (37.7%, 29/77), followed by family member or friend (gender not specified) (32.5%, 25/77), family member or friend (female-only) (13.0%, 10/77). Across nine sentinel hospitals in five Latin American countries, there was variation in coverage, with no companion at any time ranging from 14.9%-93.8%. Despite the well-known benefits and factors affecting implementation of labour companionship, more work is needed to improve equitable coverage. Concerted efforts are needed to engage with communities, health workers, health managers, and policy-makers to establish policies, address implementation barriers, and integrate data on coverage into perinatal records and quality processes to ensure that all women have access. Harmonized reporting of labour companionship would greatly enhance understanding at global level.
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Affiliation(s)
- Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Alya Hazfiarini
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Martha Vazquez Corona
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Mercedes Colomar
- The Latin American Center for Perinatology/Women´s and Reproductive Health Unit, Pan American Health Organization, Montevideo, Uruguay
| | - Bremen De Mucio
- The Latin American Center for Perinatology/Women´s and Reproductive Health Unit, Pan American Health Organization, Montevideo, Uruguay
| | - Özge Tunçalp
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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Tiruneh MG, Kebede A, Geberu DM, Feleke SF. Satisfaction with comprehensive emergency obstetric and newborn care services and associated factors among clients in University of Gondar Specialized Hospital, Northwest Ethiopia: A cross-sectional study. SAGE Open Med 2022; 10:20503121221141558. [PMID: 36505972 PMCID: PMC9729994 DOI: 10.1177/20503121221141558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Emergency obstetric and newborn care services treat 70-80% of maternal deaths. This study aimed to assess satisfaction with comprehensive emergency obstetric and newborn care (CEmONC) services and associated factors among clients in the University of Gondar Specialized Hospital. Methods Institution-based cross-sectional study was conducted on 404 participants using a systematic random sampling method. The study was conducted from March 5 to May 5, 2020, using interviewer-administered structured questionnaires. Binary logistic regression was used to find the association between independent variables and client satisfaction. The level of statistical significance was declared at a p value less than 0.05. Results The overall clients' satisfaction with CEmONC services was 65.1% (95% confidence interval (CI): 60.9-69.8). Clients' satisfaction was affected by women who had antenatal care (ANC) of three visits (adjusted odds ratio (AOR): 6.5; 95%, CI: 2.04-20.8), women waited less than 15 min (AOR: 4.15, 95% CI: 1.9-9.06), mothers stayed ⩽1 day (AOR: 0.28, 95% CI: 0.09-0.9) and 2-3 days (AOR: 0.98, 95% CI: 0.1-0.69), obtaining a welcoming environment (AOR: 4.6, 95% CI: 2.15-9.88), and getting providers explanation of examinations (AOR: 3.3, 95% CI: 1.97-5.52). Conclusion The observed clients' satisfaction with CEmONC services was suboptimal. Having ANC of three visits, waiting less than 15 min, duration of stay, obtaining a welcoming environment, and an explanation of providers' examination were the identified factors of client's satisfaction. Therefore, hospital managers and health professionals should work on the identified factors to increase the client's satisfaction with these services.
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Affiliation(s)
- Misganaw Guadie Tiruneh
- Department of Public health, College of Health Sciences, Woldia University, Woldia, Ethiopia,Misganaw Guadie Tiruneh (M.G. Tiruneh), Department of Public Health, College of Health Sciences, Woldia University, Woldia 400, Ethiopia.
| | - Adane Kebede
- Department of Health Systems and Policy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demiss Mulatu Geberu
- Department of Health Systems and Policy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Maternal satisfaction with basic emergency obstetric and new born care services and associated factors among mothers visiting public health facilities in Gedeo zone, Southern Ethiopia, 2020: A cross sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Kene C, Tekalegn Y, Dibaba D, Abdella M, Fikadu G, Atlaw D, Gomora D, Geta G, Seyoum K, Hailu S, Ejigu N, Sahiledengle B, Tasew A. Level of women-friendly care provision among mothers in immediate post-partum period at public hospitals of Southeast Ethiopia: a cross-sectional study. BMC Womens Health 2022; 22:475. [PMID: 36434654 PMCID: PMC9700868 DOI: 10.1186/s12905-022-02061-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 11/10/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The women-friendly care approach focuses on women's rights to have access to quality care for themselves as individuals, as mothers, and for their infants. However, access to quality health services is not guaranteed for many women, particularly in low and middle-income countries. Hence, this study aimed to assess the level of women-friendly care provision and associated factors among mothers in the immediate post-partum period at public hospitals of Bale Zone, Southeast Ethiopia 2021. METHODS An institutional-based cross-sectional survey was employed among mothers in the immediate post-partum period in public hospitals of Bale Zone from March 1-30, 2021. A total of 363 mothers were recruited by systematic random sampling technique in this study. Data was collected through pre-tested structured questionnaires. A 21-verified questionnaire was used to measure the outcome variable. The data were entered into Epi Data version 4.6.2.0 and exported to the statistical package of social science version 26.0 for analysis. A variable with a P value of less than 0.25 in the bi-variable binary logistic regression model was transferred to a multivariable binary logistics regression model. Hosmer and Lemeshow's goodness of fit model was checked. Adjusted odds ratio with 95% confidence intervals were used to estimate the strength of association between the outcome variable and independent variables. A p-value less than 0.05 was considered as significantly associated. RESULTS The level of women-friendly care provision among mothers in immediate post-partum at public hospitals of Bale Zone was found to be 61% [95% confidence interval (55.73-66.04)]. Being prim para mother [Adjusted odds ratio = 1.88(1.07-3.33)], having planned pregnancy [Adjusted odds ratio = 1.94(1.04-3.63)] and staying at a health facility after delivery [Adjusted odds ratio = 4.8(1.71-13.39)] were found to be statistically significant predictors of level of women-friendly care provision. CONCLUSION The women-friendly care provision among mothers in the immediate post-partum period in this study area was found to be low against most of the pre-existing findings. Strong counseling on planned pregnancy and staying at a health facility after delivery is recommended.
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Affiliation(s)
- Chala Kene
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Yohannes Tekalegn
- Public Health Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Diriba Dibaba
- Public Health Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Mujib Abdella
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Genet Fikadu
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, School of Medicine, Madda Walabu University, Bale-Goba, Ethiopia
| | - Degefa Gomora
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Girma Geta
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Kenbon Seyoum
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Sintayehu Hailu
- Public Health Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Neway Ejigu
- Midwifery Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Biniyam Sahiledengle
- Public Health Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Alelign Tasew
- Public Health Department, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
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Bishaw KA, Temesgen H, Amha H, Desta M, Bazezew Y, Ayenew T, Eshete T, Bewket B, Mulugeta H, Tiruneh GA. A systematic review and meta-analysis of women's satisfaction with skilled delivery care and the associated factors in Ethiopia. SAGE Open Med 2022; 10:20503121211068249. [PMID: 35083043 PMCID: PMC8785278 DOI: 10.1177/20503121211068249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022] Open
Abstract
Evidence of variation in maternity health service practices has increased the government's interest in quantifying and advancing the quality of institutional delivery care in the developing world, including Ethiopia. Therefore, we conducted a systematic review and meta-analysis to update and provide more representative data on women's satisfaction with skilled delivery care and the associated factors in Ethiopia. This systematic review and meta-analysis followed the Preferred Reporting Items 2015 guideline. We searched PubMed/Medline, SCOPUS, Embase, Web of Science, and Google Scholar electronic databases for all 36 included studies. The pooled prevalence of women's satisfaction with skilled delivery care and the associated factors were estimated using a random-effects model. Subgroup analysis and meta-regression were performed to identify the source of heterogeneity. Furthermore, publication bias was checked using eggers and funnel plots. All statistical analyses were performed using STATA version 14.0 software. The pooled prevalence of women's satisfaction with skilled delivery care was 67.31 with 95% confidence interval (60.18-74.44). Wanted pregnancy (adjusted odds ratio = 2.86, 95% confidence interval: (2.24-3.64)), having a plan to deliver at a health facility (adjusted odds ratio = 2.09, 95% confidence interval: (1.42-3.09)), access to ambulance service (adjusted odds ratio = 1.52, 95% confidence interval: (1.00-2.31)), waiting time < 15 min (adjusted odds ratio = 3.66, 95% confidence interval: (2.51-5.33)), privacy assured (adjusted odds ratio = 3.94, 95% confidence interval: (2.23-6.94)), short duration of labour < 12 hr (adjusted odds ratio = 2.55, 95% confidence interval: (1.58-4.12)), proper labour pain management (adjusted odds ratio = 3.01, 95% confidence interval: (1.46-6.22)), and normal newborn outcome (adjusted odds ratio = 3.94, 95% confidence interval: (2.17-7.15)) were associated with women's satisfaction. Almost two-thirds of women were satisfied with skilled delivery care. In comparison, the remaining one-third were not satisfied with the care. The quality of intrapartum care, unwanted pregnancy, lack of ambulance services, prolonged duration of labour, poor labour pain management, and complicated newborn outcome were factors affecting women's satisfaction with skilled delivery care in Ethiopia. Therefore, strategies need to be developed to increase the satisfaction level by considering the abovementioned factors during routine delivery care.
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Affiliation(s)
- Keralem Anteneh Bishaw
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Habtamu Temesgen
- Department of Human Nutrition and Food Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Haile Amha
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yibelu Bazezew
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Ayenew
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tewodros Eshete
- Department of Health Informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Bewket
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Henok Mulugeta
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Gurara A, Kedir F, Yami D, Beyen T. Factors associated with compassionate and respectful maternity care among laboring mothers during childbirth in Ethiopia. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2022. [DOI: 10.4103/jnms.jnms_127_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Eziawdres D, Worku W, Taye M. Maternal Satisfaction With Delivery Services and its Associated Factors Among Mothers Who Gave Birth at Public Health Centers in Yeka Sub City, Addis Ababa, Ethiopia. Health Serv Insights 2021; 14:11786329211050722. [PMID: 34707363 PMCID: PMC8543559 DOI: 10.1177/11786329211050722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/09/2021] [Indexed: 11/15/2022] Open
Abstract
This study aimed to assess maternal satisfaction and associated factors with delivery care services uptake among mothers who gave birth at public health centers. An institution-based cross-sectional study was conducted in the Yeka Sub-City in Addis Ababa, Ethiopia. A systematic sampling technique was used to select mothers. Bivariable and multivariable analysis was done to identify associated variables. The overall mothers’ satisfaction with delivery care services uptake was 63%. The median age of the participants was 28 years. In multivariable analysis privacy measures taken at delivery care services uptake, mothers’ education level, occupational status of mothers, and family income level of mothers were associated with mothers’ satisfaction in delivery care services. Mother’s income levels of 1501 to 5000 birr were satisfied with the service (AOR = 2.49; 95% CI: 1.3, 4.76). However, mothers whose income below1500 birr were dissatisfied. In conclusion, a mother’s educational level, occupational status, and family income affect mothers’ satisfaction with delivery care services uptake in public health centers, in the Yeka Sub-City. Evaluating health care services uptake from the client’s point of view and targeting to identify problems is very necessary.
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Affiliation(s)
- Daniel Eziawdres
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Walelegn Worku
- Department of Occupational and Environmental Health, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, Central Gondar, Ethiopia
| | - Molla Taye
- Department of Anatomy, School of Medicine, College of Medicine and Health Sciences, The University of Gondar, Central Gondar, Ethiopia
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Biresaw H, Mulugeta H, Endalamaw A, Yesuf NN, Alemu Y. Patient satisfaction towards health care services provided in Ethiopian health institutions: a systematic review and meta-analysis. Health Serv Insights 2021; 14:11786329211040689. [PMID: 34511929 PMCID: PMC8424599 DOI: 10.1177/11786329211040689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
The level of patient satisfaction is a direct or indirect measure of services delivered in healthcare institutions. Different primary studies in Ethiopia showed the proportion of satisfied patients toward health services. Patient satisfaction reflects a wide gap between the current experience and the expected services and pushes clients to go to farther located health care facilities and even to more expensive private health care facilities to find quality healthcare services. Inconsistent findings regarding the proportion of patients that are satisfied with the healthcare services in Ethiopia make generalizations difficult at the national level. We have accessed previous studies through an electronic web-based search strategy using PubMed, Cochrane Library, Google Scholar, Embase, and CINAHL and a combination of search terms. The quality of each included article was assessed using a modified version of the Newcastle-Ottawa Scale for cross-sectional studies. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was carried out using a random-effects method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for reporting results. Out of 188 records screened, 41 studies with 17 176 participants fulfilled the inclusion criteria and were included for proportion estimation. The pooled proportion of satisfied patients was 63.7%. Attending a health center (AOR = 2.68; 95% CI = 1.79, 2.85), being literate (AOR = 0.46; 95% CI = 0.28-0.64), being younger than 34 years old (AOR = 2.07; 95% CI = 1.28, 2.85), and being divorced (AOR = 0.58; 95% CI = 0.38, 0.88) were factors identified as being associated with patient satisfaction. The proportion of patient satisfaction in Ethiopia was high based on over 50% satisfaction scale. The Ministry of Health should give more emphasis to improve hospital health care services to further improve patient satisfaction.
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Affiliation(s)
- Henok Biresaw
- Department of Adult health Nursing, College of Health Sciences and Medicine, Bahir Dar University, Bahir Dar, Ethiopia
| | - Henok Mulugeta
- Department of Nursing, College of Health Sciences and Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, College of Health Sciences and Medicine, Bahir Dar University, Bahir Dar, Ethiopia
| | - Nurhusien Nuru Yesuf
- Department of Surgical Nursing, College of Health Sciences and Medicine, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Alemu
- Department of Reproductive Health, College of Health Sciences and Medicine, Bahir Dar University, Bahir Dar, Ethiopia
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Antenatal care service satisfaction and its associated factors among pregnant women in public health centres in Hawassa city, Southern Ethiopia. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211007881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Self-reported client satisfaction is vital in order to address service provider and facility-based factors that can be upgraded to maximise antenatal care (ANC) satisfaction and utilisation in service-providing institutions. Objective: This study aimed to assess ANC service satisfaction and associated factors among pregnant women attending Hawassa city public health centres (HC), Sidama regional state, Southern Ethiopia. Methods: This health facility–based cross-sectional study was conducted on 422 pregnant women from 14 March to 13 April 2017. Exit interview data were collected from pregnant women attending care service at five randomly selected public HC. Results: Overall, 79.2% were satisfied with the ANC service. As per specific components, 74.2% of respondents were satisfied with the information provided, and 74.2% were satisfied with the institution’s health care. Respondents who had received iron tablets were 3.2 times more likely to be satisfied than their counterparts (adjusted odds ratio (AOR)=3.2, 95% confidence interval (CI) 1.7–5.9). Pregnant women who were counselled on human immunodeficiency virus infection and its testing were 4.3 times more likely to be satisfied than those who had not received such counselling (AOR=4.3, 95% CI 2.2–8.4). Also, those women who waited ⩽30 minutes (AOR=2.6, 95% CI 1.2–5.5) and who received information on foetal movement (AOR=3.5, 95% CI 1.8–6.5) were significantly associated with ANC service satisfaction. Conclusion: More than 20% of pregnant women were not satisfied with ANC services. This reflects a need for attention in each aspect of health-care service provision in order to assure client satisfaction.
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Debela AB, Mekuria M, Kolola T, Bala ET, Deriba BS. Maternal Satisfaction and Factors Associated with Institutional Delivery Care in Central Ethiopia: a Mixed Study. Patient Prefer Adherence 2021; 15:387-398. [PMID: 33642855 PMCID: PMC7903958 DOI: 10.2147/ppa.s297662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Women satisfaction recognized as an important outcome of the maternal health care delivery system. Despite the Ethiopian federal ministry of health implemented compassionate, respectful, and caring as one of the health sector transformation agendas to increase health service utilization, the level of maternal satisfaction of institutional delivery is still low. This study aimed to assess maternal satisfaction and factors associated with institutional delivery care in central Ethiopia. METHODS Community-based cross-sectional study, which involved quantitative study supplemented with qualitative methods were employed. Mothers were proportionally allocated to each selected kebele according to the number of their size. Data were collected by a face-to-face interview using a standardized questionnaire to determine the level of maternal satisfaction with birth care. The result was presented using texts, percentages, and tables. Bivariate and multivariate logistic regressions were performed between dependent and independent variables at 95% confidence intervals and a P-value < 0.05 to show a significant association. In the qualitative part, data were transcribed carefully and analyzed thematically. RESULTS The overall a total of 451 respondents participated in this study making a response rate of 98%. The level of maternal satisfaction was 36.6% in this study. Spontaneous vaginal deliveries (SVD) (AOR: 7.33, CI: 2, 26.79), being attended by female sex health workers (AOR: 1.54, CI: 1.04, 2.28), receiving ambulance service to arrive at health facilities (AOR: 7.84, CI: 2, 61.63), utilizing of maternal waiting areas AOR: 1.72, CI: 1.09, 2.66), and respectful care (AOR=1.55, CI: 1.03, 2.34) were factors associated with maternal satisfaction. From qualitative study, three themes and ten categories have emerged. CONCLUSION Maternal satisfaction towards the delivery service was low. SVD, being attended by female sex health workers, ambulance service, cleaned delivery room, and respectful care were factors associated with maternal satisfaction. The health facilities in the study areas need to work on improving health facility cleanliness, health workers' compassionate and respectful care, and providing ambulance service as a main means of transportation for laboring mothers.
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Affiliation(s)
| | - Mulugeta Mekuria
- Department of Public Health, Ambo University College of Medicine and Health Sciences, Ambo, Ethiopia
| | - Tufa Kolola
- Department of Public Health, Ambo University College of Medicine and Health Sciences, Ambo, Ethiopia
| | - Elias Teferi Bala
- Department of Public Health, Ambo University College of Medicine and Health Sciences, Ambo, Ethiopia
| | - Berhanu Senbeta Deriba
- Salale University College of Health Sciences Department of Public Health, Fitche, Ethiopia
- Correspondence: Berhanu Senbeta Deriba Email
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Zenbaba D, Sahiledengle B, Dibaba D, Bonsa M. Utilization of Health Facility-Based Delivery Service Among Mothers in Gindhir District, Southeast Ethiopia: A Community-Based Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211056061. [PMID: 34806455 PMCID: PMC8606949 DOI: 10.1177/00469580211056061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility-based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility-based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility-based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.
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Affiliation(s)
- Demisu Zenbaba
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
| | | | - Diriba Dibaba
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
| | - Mitiku Bonsa
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
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Determinants of Maternal Satisfaction with Existing Delivery Care at Wolaita Sodo University Teaching and Referral Hospital, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6403123. [PMID: 33029519 PMCID: PMC7533011 DOI: 10.1155/2020/6403123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 11/20/2022]
Abstract
Background Assessing maternal satisfaction on delivery service has significant public health importance to measure the quality of maternal and child care services in a country. Therefore, the objective of this study was to further investigate the determinants of maternal satisfaction on delivery service provided at the Woliata Sodo University Teaching and Referral Hospital, Ethiopia. Methods An institutionally based cross-sectional study was employed at the Wolaita Sodo University Hospital, Ethiopia. All mothers who gave birth between March and May 2018 were included in the study. Data were collected through using a pretested and structured interviewer-administered questionnaire. Both bivariate and multivariable logistic regression analyses were performed. A P value of <0.05 was used to declare statistical significance. Result A total of 398 delivered mothers were included in the study. The rate of maternal satisfaction on existing delivery care was found to be 67.3%. Being less educated (AOR = 5.06, [2.22-11.53]), primigravida (AOR = 3.59, [1.17-11.04]), planned and wanted pregnancy (AOR = 2.74, [1.21-6.18]), having antenatal care follow-up for current pregnancy (AOR = 4.48, [2.04-9.83]), ever used family planning service (AOR = 3.83, [1.95-67.52]), labor duration of less than 6 hours (AOR = 5.96, [2.61-13.57]), and spontaneous vaginal delivery (AOR = 2.82, [1.07-7.42]) were factors significantly associated with maternal satisfaction. Conclusion In this study setting, maternal satisfaction was lower compared to other studies. Unreserved effort should be considered for future interventions.
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Demis A, Getie A, Wondmieneh A, Bimerew M, Alemnew B, Gedefaw G. Women's satisfaction with existing labour and delivery services in Ethiopia: a systematic review and meta-analysis. BMJ Open 2020; 10:e036552. [PMID: 32709648 PMCID: PMC7380852 DOI: 10.1136/bmjopen-2019-036552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To estimate the pooled prevalence of women's satisfaction with existing labour and delivery services in Ethiopia. DESIGN Systematic review and meta-analysis. METHODS MEDLINE/PubMed, Scopus, Hinari, Google Scholar and web of science electronic databases were searched for the study. This meta-analysis included nineteen cross-sectional studies. Cochrane I2 statistics were used to check the heterogeneity of the studies. Subgroup and sensitivity analysis were conducted with the evidence of heterogeneity. Egger test with funnel plot were used to investigate publication bias. RESULT Nineteen studies were included in the systematic review and meta-analysis. The overall prevalence of women's satisfaction with existing labour and delivery services in Ethiopia was 70.54% (95% CI 60.94 to 80.15). Having informal education of the women (adjusted OR (AOR)=2.19; 95% CI 1.47 to 3.25), time to be seen by the healthcare providers within 20 min (AOR=2.97; 95% CI 2.11 to 4.19), receiving free service (AOR=5.01; 95% CI 2.87 to 8.75), keeping women privacy (AOR=2.84; 95% CI 1.46 to 5.55), planned delivery in the health institution (AOR=2.85; 95% CI 1.99 to 4.07), duration of labour within 12 hours (AOR=2.55; 95% CI 1.70 to 3.81) and have not antenatal care follow-up (AOR=4.03; 95% CI 2.21 to 7.35) were factors associated with women satisfaction with labour and delivery services in Ethiopia. CONCLUSION The pooled prevalence of women's satisfaction with existing labour and delivery services was high. Informal education of the women, antenatal care follow-up, planned delivery in the health institution, keeping women privacy, getting free service, time to be seen by the healthcare providers and duration of labour were factors associated with women's satisfaction during labour and delivery services. This finding is important to design strategic policies and to prevent emergency neonatal and women complications during the childbirth and postpartum periods. PROSPERO REGISTRATION NUMBER CRD42020149217.
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Affiliation(s)
| | | | | | | | - Birhan Alemnew
- Medical Laboratory Sciences, Woldia University, Woldia, Ethiopia
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Bulto GA, Demissie DB, Tasu TL, Demisse GA. Mother's satisfaction with the existing labor and delivery care services at public health facilities in West Shewa zone, Oromia region, Ethiopia. BMC Pregnancy Childbirth 2020; 20:303. [PMID: 32429878 PMCID: PMC7236095 DOI: 10.1186/s12884-020-02998-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/07/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mothers' satisfaction with care during childbirth is indicators of the quality care which affects skilled birth attendance. Negative client's experiences at health facilities cause them to delay or avoid seeking care, which highlights services providers should consider and act on the expectations and experiences of women and their families. Though there are few studies conducted in Ethiopia on maternal satisfaction with Labor and Delivery (LAD) services, there is no study conducted in the study area. Therefore the study aims to assess the mother's satisfaction with existing LAD services and associated factors at all levels of health care in the West Shewa zone. METHODS An institution-based cross-sectional study was conducted at public health facilities in West Shewa zone, Central Ethiopia. A systematic sampling technique was used to select 560 respondents by using their delivery registration number and data were collected through face to face interview. Mothers were considered satisfied if they responded satisfied/very satisfied with 75% or more of the questions assessing satisfaction. Binary and multivariable logistic regression analysis was used to identify associated factors. RESULTS The overall proportion of mothers who were satisfied with the current LAD care services were 60.8%. The main areas of dissatisfaction were; accessibility and cleanness of toilets/shower 72.6%, overall cleanness of the facility/including waiting-area 40.1% and presence of support a person during birth 38.0%. The presence of cultural practices (AOR = 2.5), discussion on the place of delivery with health worker during ANC (AOR = 1.75), providers asks for consent before procedure (AOR = 2.77), encouraging companion to remain with mother (AOR = 2.22), never leave mother alone or unattended (AOR = 2.56), giving periodic updates on status and progress of labor (AOR = 2.04) and explaining what is being done and to expect during LAD (AOR = 2.20) were factors identified to be significantly associated with satisfaction on LAD services. CONCLUSION The overall satisfaction of mothers with LAD services at public health facilities in the West-Shewa zone was relatively low. Presence of cultural practices, discussion on the place of delivery, asking for consent before the procedure, encouraging companion to remain with mothers and explaining what is being done were factors identified. Therefore, all stakeholders have to emphatically work on those identified factors to improve mothers' satisfaction with LAD services.
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Affiliation(s)
- Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Dereje Bayissa Demissie
- Department of Neonatal Nursing, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tefera Likasa Tasu
- Department of Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Getu Alemu Demisse
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Maternal satisfaction towards childbirth Service in Public Health Facilities at Adama town, Ethiopia. Reprod Health 2020; 17:60. [PMID: 32375824 PMCID: PMC7201691 DOI: 10.1186/s12978-020-00911-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal satisfaction towards childbirth service is related to the quality of care. Promotion of patient satisfaction is essential for preventing patient anxiety, promoting treatment adherence, preventing disease, and health promotion. This study was aimed at assessing the satisfaction and associated factors among mothers who visit public health facilities in Adama town for childbirth service. METHODS An institution based cross-sectional study design was conducted at public health facilities in Adama town from June 01 to June 30, 2018. Four hundred seventy-seven mothers were selected using a systematic random sampling method. Bivariate and multivariate logistic regressions were conducted to identify predictors of maternal satisfaction towards childbirth service by considering p-value less than 0.05. RESULTS The study revealed that 357 (74.8%) were satisfied with the services. Factors which showed a significant association with satisfaction were 25-34 age group (AOR; 2.026, 95%CI:1.056,3.887), no formal education (AOR;2.810, 95%CI;1.085,7.278), planned childbirth (AOR; 1.823,95%CI;1.024,3.246), wait time of less than 1 h (AOR;11.620,95%CI;3.619,37.309) and wait time of one to 2 h (AOR;19.620, 95%CI;2.349,68.500). CONCLUSION Three-quarters of the mothers were satisfied with childbirth services. Age, educational status, reason for visit and wait time were found to have a significant association with maternal satisfaction of childbirth services.
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Maternal Satisfaction with Intrapartum Nursing Care and Its Associated Factors among Mothers Who Gave Birth in Public Hospitals of North Wollo Zone, Northeast Ethiopia: Institution-Based Cross-Sectional Study. J Pregnancy 2020; 2020:8279372. [PMID: 32395345 PMCID: PMC7201724 DOI: 10.1155/2020/8279372] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/11/2020] [Accepted: 03/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Now a day, satisfaction had been identified as the major index to assess the quality of health-care provision in the world including Ethiopia. Mothers judge the quality of intrapartum care received based on their satisfaction with the services provided, thus influencing their utilization of the available health facilities. Therefore, this study aimed to assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in North Wollo Zone, Northeastern Ethiopia, 2019. Methods Institutional-based cross-sectional quantitative study was conducted in public hospitals of North Wollo Zone, and a total of 398 study participants were selected by using a systematic random sampling method. Data was collected using a standardized questionnaire by direct interviewing of study participants, and data was analyzed using SPSS 24 versions to determine the frequency of variables. Logistic regression was carried out to identify factors associated with maternal satisfaction. Results From the total of 398 study participants, about 51% of women were satisfied with the hospital-based intrapartum nursing care. Being rural in residency (AOR: 2.03; 95% CI: 1.05-3.93), time to be seen by health-care providers (AOR: 2.82; 95% CI: 1.46-5.46), having history of ANC follow-up (AOR: 3.73; 95% CI: 1.12-12.57), and getting adequate meal (AOR: 3.96; 95% CI: 1.13-13.83) had showed statistical significant association with maternal satisfaction. Conclusion In this study, the overall maternal satisfaction with intrapartum nursing care was low. Therefore, improving ANC follow-up, early examined by health-care providers, and getting adequate meal while in labour and delivery might enhance women satisfaction with intrapartum nursing care services.
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Bante A, Teji K, Seyoum B, Mersha A. Respectful maternity care and associated factors among women who delivered at Harar hospitals, eastern Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth 2020; 20:86. [PMID: 32041564 PMCID: PMC7011506 DOI: 10.1186/s12884-020-2757-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/21/2020] [Indexed: 12/25/2022] Open
Abstract
Background In Ethiopia, approximately three-fourths of mothers do not deliver in health facilities. Disrespect and abuse during childbirth fallouts in underutilization of institutional delivery that upshots maternal morbidity and mortality. Thus, the ambition of this study was to assess respectful maternity care and associated factors in Harar hospitals, Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted from April 01 to July 01, 2017. A total of 425 women, delivered at Harar town hospitals, were nominated using a systematic random sampling technique. A pretested and organized questionnaire was used to collect the data. After checking for completeness, the data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for cleaning and analyses. Both bivariate and multivariable logistic regression was computed to identify factors associated with respectful maternity care. Statistical significance was declared at a P-value of < 0.05. Results Data were collected on 425 women. Overall, only 38.4% (95% CI: 33.7, 42.0%) of women received respectful maternity care. Delivering at private hospitals [AOR: 2.3, 95% CI: 1.25, 4.07], having ANC follow-up [AOR: 1.8, 95% CI: 1.10, 3.20], planned pregnancy [AOR: 3.0, 95% CI: 1.24, 7.34], labor attended by male provider [AOR: 1.8, 95% CI: 1.14, 2.77] and normal maternal outcome [AOR: 2.3, 95% CI: 1.13, 4.83] were significantly associated with respectful maternity care. Conclusions Only four out of ten women received respectful care during labor and delivery. Providing women-friendly, abusive free, timely and discriminative free care are the bases to improve the uptake of institutional delivery. Execution of respectful care advancement must be the business of all healthcare providers. Furthermore, to come up with a substantial reduction in maternal mortality, great emphasis should be given to make the service woman-centered.
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Affiliation(s)
- Agegnehu Bante
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Kedir Teji
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhanu Seyoum
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Mersha
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Gejea T, Abadiga M, Hasen T. Maternal Satisfaction with Delivery Services of Government Hospitals in Ambo Town, West Shoa Zone, Oromia Region, Ethiopia, 2020. Patient Prefer Adherence 2020; 14:1225-1235. [PMID: 32801653 PMCID: PMC7383021 DOI: 10.2147/ppa.s251635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Maternal satisfaction with delivery service is used to measure the ability of services provided to meet consumers' expectations. Satisfying women with the care given during labor and delivery helps to develop a positive childbirth experience and a favorable attitude towards motherhood. There were limited studies that assessed maternal satisfaction in Ethiopia, and this study aimed to assess delivery service satisfaction and its associated factors among mothers who gave birth at public hospitals of Ambo town, West Ethiopia. METHODS Institutional-based cross-sectional study was conducted on 384 women, from April 20 to May 20, 2019, in public hospitals of Ambo town. The study participants were selected by systematic random sampling method and interviewed using structured questionnaires. The data were checked, coded and entered into Epi info version 7, and then exported to SPSS version 20 for analysis. Multivariable logistic regression analysis was performed to identify predictors of maternal satisfaction. A variable with a P value of less than 0.05 was considered statistically significant. RESULTS A total of 384 study participants were involved, making a response rate of 100%. Out of 384 mothers who participated in the study, 322 (83.9%) were satisfied with the delivery service, and 62 (16.1%) were unsatisfied with the delivery service. Monthly income less than 650 ETB (AOR=0.46, 95% CI: 0.22, 0.94) was associated with decreased maternal satisfaction. On the other hand, normal birth outcome (AOR=4.409, 95% CI: 1.453, 13.375) and maintenance of mothers' privacy (AOR = 8.405, 95% CI: 1.74,29.59) were associated with increased maternal satisfaction with delivery services. CONCLUSION The level of maternal satisfaction with the delivery services in this study was moderate. Monthly income, maternal birth outcome and maintenance of privacy were significantly associated with maternal satisfaction.
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Affiliation(s)
- Teshome Gejea
- School of Nursing and Midwifery, Institute of Health Sciences, Ambo University Referral Hospital, Ambo, Ethiopia
| | - Muktar Abadiga
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- Correspondence: Muktar Abadiga Email
| | - Tahir Hasen
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Mocumbi S, Högberg U, Lampa E, Sacoor C, Valá A, Bergström A, von Dadelszen P, Munguambe K, Hanson C, Sevene E. Mothers' satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique. BMC Pregnancy Childbirth 2019; 19:303. [PMID: 31426758 PMCID: PMC6701029 DOI: 10.1186/s12884-019-2449-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Background Client satisfaction is an essential component of quality of care. Health system factors, processes of care as well as mothers’ characteristics influence the extent to which care meets the expectations of mothers and families. In our study, we specifically aimed to address the mothers’ experiences of, and satisfaction with, care during childbirth. Methods A population-based cross-sectional study, using structured interviews with published sequences of questions assessing satisfaction, including 4358 mothers who gave birth during the 12 months before June 2016 to estimate satisfaction with childbirth care. Regression analysis was used to determine the predictors of client satisfaction. Results Most mothers (92.5%) reported being satisfied with care during childbirth and would recommend that a family member to deliver at the same facility. Specifically, 94.7% were satisfied with the cleanliness of the facility, 92.0% reported being satisfied with the interaction with the healthcare providers, but only 49.8% felt satisfied with the assistance to feed their baby. Mothers who had negative experiences during the process of care, such as being abandoned when needing help, disrespect, humiliation, or physical abuse, reported low levels of satisfaction when compared to those who had not had such experiences (68.5% vs 93.5%). Additionally, they reported higher levels of dissatisfaction (20.1% vs 2.1%). Regression analysis revealed that mothers who gave birth in primary level facilities tended to be more satisfied than those who gave birth in hospitals, and having a companion increased, on average, the overall satisfaction score, with 0.06 in type II health centres (CI 0.03–0.10) and with 0.05 in type I health centres (CI − 0.02 – 0.13), compared to − 0.01(CI -0.08 – 0.07) in the hospitals, irrespective of age, education and socio-economic background. Conclusion Childbirth at the primary level facilities contributes to the level of satisfaction. The provision of childbirth care should consider women’s preferences and needs, including having a companion of choice. We highlight the challenge in balancing safety of care versus satisfaction with care and in developing policies on the optimum configuration of childbirth care. Interventions to improve the interaction with providers and the provision of respectful care are recommended. Electronic supplementary material The online version of this article (10.1186/s12884-019-2449-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sibone Mocumbi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Av. Salvador Allende 702, 1100, Maputo, Mozambique. .,Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Centre, Uppsala University, Dag Hammarskjölds väg 38, 751 85, Uppsala, Sweden
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique
| | - Anifa Valá
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique
| | - Anna Bergström
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.,University College London, Institute for Global Health, Gower St, London, WC1E 6BT, UK
| | - Peter von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, 1 Lambeth Palace Road, London, SE1 7EU, UK
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique.,Department of Public Health, Faculty of Medicine, Universidade Eduardo Mondlane, Av. Salvador Allende 702 R/C, Maputo, Mozambique
| | - Claudia Hanson
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavagen 18A, Plan 4, Stockholm, Sweden.,Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique.,Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Universidade Eduardo Mondlane, Av. Salvador Allende 702 R/C, Maputo, Mozambique
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Adjei KK, Kikuchi K, Owusu-Agyei S, Enuameh Y, Shibanuma A, Ansah EK, Yasuoka J, Poku-Asante K, Okawa S, Gyapong M, Tawiah C, Oduro AR, Sakeah E, Sarpong D, Nanishi K, Asare GQ, Hodgson A, Jimba M. Women's overall satisfaction with health facility delivery services in Ghana: a mixed-methods study. Trop Med Health 2019; 47:41. [PMID: 31320830 PMCID: PMC6612170 DOI: 10.1186/s41182-019-0172-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/26/2019] [Indexed: 11/10/2022] Open
Abstract
Background Skilled birth delivery has increased up to nearly 74% in Ghana, but its quality has been questioned over the years. As understanding women's satisfaction could be important to improving service quality, this study aimed to determine what factors were associated with women's overall satisfaction with delivery services quantitatively and qualitatively in rural Ghanaian health facilities. Results This cross-sectional, mixed methods study used an explanatory sequential design across three Ghana Health Service research areas in 2013. Participants were women who had delivered in the preceding 2 years. Two-stage random sampling was used to recruit women for the quantitative survey. Relationships between women's socio-demographic characteristics and their overall satisfaction with health facility delivery services were examined using univariate and multiple logistic regression analyses. For qualitative analyses, women who completed the quantitative survey were purposively selected to participate in focus group discussions. Data from the focus group discussions were analyzed based on predefined and emerging themes. Overall, 1130 women were included in the quantitative analyses and 136 women participated in 15 focus group discussions. Women's mean age was 29 years. Nearly all women (94%) were satisfied with the overall services received during delivery. Women with middle level/junior high school education [adjusted odds ratio (AOR) = 0.50, 95% confidence interval (CI) = (0.26-0.98)] were less likely to be satisfied with overall delivery services compared to women with no education. Qualitatively, women were not satisfied with the unconventional demands, negative attitude, and unavailability of healthcare workers, as well as the long wait time. Conclusions Although most women were satisfied with the overall service they received during delivery, they were not satisfied with specific aspects of the health services; therefore, higher quality service delivery is necessary to improve women's satisfaction. Additional sensitivity training and a reduction in work hours may also improve the experience of clients.
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Affiliation(s)
- Kwame K Adjei
- 1Kintampo Health Research Centre, Kintampo, Brong-Ahafo Ghana
| | - Kimiyo Kikuchi
- 2Institute of Decision Science for a Sustainable Society, Kyushu University, Fukuoka, Japan
| | - Seth Owusu-Agyei
- 1Kintampo Health Research Centre, Kintampo, Brong-Ahafo Ghana.,3University of Health and Allied Science, Ho, Ghana
| | - Yeetey Enuameh
- 1Kintampo Health Research Centre, Kintampo, Brong-Ahafo Ghana.,4Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Akira Shibanuma
- 5Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Evelyn Korkor Ansah
- 3University of Health and Allied Science, Ho, Ghana.,11Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Junko Yasuoka
- 6Research and Education Center for Prevention of Global Infectious Diseases of Animals, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | | | - Sumiyo Okawa
- 5Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | | | | | | | | | - Doris Sarpong
- 8Dodowa Health Research Centre, Dodowa, Greater Accra Ghana
| | - Keiko Nanishi
- 9Office of International Academic Affairs, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Abraham Hodgson
- 11Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Masamine Jimba
- 5Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
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Dalinjong PA, Wang AY, Homer CSE. Are health facilities well equipped to provide basic quality childbirth services under the free maternal health policy? Findings from rural Northern Ghana. BMC Health Serv Res 2018; 18:959. [PMID: 30541529 PMCID: PMC6292018 DOI: 10.1186/s12913-018-3787-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Basic inputs and infrastructure including drugs, supplies, equipment, water and electricity are required for the provision of quality care. In the era of the free maternal health policy in Ghana, it is unclear if such basic inputs are readily accessible in health facilities. The study aimed to assess the availability of basic inputs including drugs, supplies, equipment and emergency transport in health facilities. Women and health providers' views on privacy and satisfaction with quality of care were also assessed. METHODS The study used a convergent parallel mixed methods in one rural municipality in Ghana, Kassena-Nankana. A survey among facilities (n = 14) was done. Another survey was carried out among women who gave birth in health facilities only (n = 353). A qualitative component involved focus group discussions (FGDs) with women (n = 10) and in-depth interviews (IDIs) with midwives and nurses (n = 25). Data were analysed using descriptive statistics for the quantitative study, while the qualitative data were recorded, transcribed, read and coded using themes. RESULTS The survey showed that only two (14%) out of fourteen facilities had clean water, and five (36%) had electricity. Emergency transport for referrals was available in only one (7%) facility. Basic drugs, supplies, equipment and infrastructure especially physical space were inadequate. Rooms used for childbirth in some facilities were small and used for multiple purposes. Eighty-nine percent (n = 314) of women reported lack of privacy during childbirth and this was confirmed in the IDIs. Despite this, 77% of women (n = 272) were very satisfied or satisfied with quality of care for childbirth which was supported in the FGDs. Reasons for women's satisfaction included the availability of midwives to provide childbirth services and to have follow-up homes visits. Some midwives were seen to be patient and empathetic. Providers were not satisfied due to health system challenges. CONCLUSION Government should dedicate more resources to the provision of essential inputs for CHPS compounds providing maternal health services. Health management committees should also endeavour to play an active role in the management of health facilities to ensure efficiency and accountability. These would improve quality service provision and usage, helping to achieve universal health coverage.
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Affiliation(s)
| | - Alex Y Wang
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caroline S E Homer
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Gitobu CM, Gichangi PB, Mwanda WO. Satisfaction with Delivery Services Offered under the Free Maternal Healthcare Policy in Kenyan Public Health Facilities. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:4902864. [PMID: 29951103 PMCID: PMC5987322 DOI: 10.1155/2018/4902864] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/28/2018] [Accepted: 04/17/2018] [Indexed: 11/18/2022]
Abstract
Background Patients' satisfaction is an individual's positive assessment regarding a distinct dimension of healthcare and the perception about the quality of services offered in that health facility. Patients who are not satisfied with healthcare services in a certain health facility will bypass the facility and are unlikely to seek treatment in that facility. Objective To determine satisfaction level of mothers with the free maternal services in selected Kenyan public health facilities after the implementation of the free maternal healthcare policy. Methods Data was collected through a quantitative exit survey questionnaire. The respondents were mothers who had delivered in the health facilities and were waiting to leave the health facilities after discharge. The sample included 2,216 mothers in 77 public health facilities across 14 counties in Kenya under tier 3 and tier 4 categories. The number of respondents to be interviewed was proportionately arrived at based on each health facility's bed capacity. Results The study established a satisfaction rate of 54.5% among the beneficiaries of the free maternal healthcare services in the country. Mothers benefiting from the free delivery services were satisfied with communication by the healthcare workers, staff availability in the delivery rooms, availability of staff in the wards, and drug and supplies availability (>56%) but unsatisfied with consultation time, cleanliness, and privacy in the wards (<56%). High education levels and lengthy stay in healthcare facilities were negatively associated with the satisfaction with the free delivery services (P < 0.05). Conclusion There is a high satisfaction with the free maternal healthcare services in Kenya. However, the implementation of the free maternal healthcare policy was associated with low privacy, poor hygiene, and low consultation time in the health facilities. Therefore there is need to address these service gaps so as to attract more mothers to deliver in public health facilities.
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Rivenes Lafontan S, Sundby J, Ersdal HL, Abeid M, Kidanto HL, Mbekenga CK. "I Was Relieved to Know That My Baby Was Safe": Women's Attitudes and Perceptions on Using a New Electronic Fetal Heart Rate Monitor during Labor in Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020302. [PMID: 29425167 PMCID: PMC5858371 DOI: 10.3390/ijerph15020302] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/05/2018] [Accepted: 02/07/2018] [Indexed: 10/31/2022]
Abstract
To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively. We carried out 20 semi-structured individual interviews post-labor at two hospitals in Tanzania. A thematic content analysis was used to analyze the data. Our results indicated that the use of the monitor positively affected the women's birth experience. It provided much-needed reassurance about the wellbeing of the child. The women considered that wearing Moyo improved care due to an increase in communication and attention from birth attendants. However, the women did not fully understand the purpose and function of the device and overestimated its capabilities. This highlights the need to improve how and when information is conveyed to women in labor.
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Affiliation(s)
- Sara Rivenes Lafontan
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway.
| | - Johanne Sundby
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway.
| | - Hege L Ersdal
- Department of Anesthesiology and Intensive Care, University of Stavanger, 4036 Stavanger, Norway.
| | | | - Hussein L Kidanto
- Ministry of Health Community Development Gender Elderly and Children, Dodoma, Tanzania.
| | - Columba K Mbekenga
- School of Nursing and Midwifery, Aga Khan University, Dar es Salaam, Tanzania.
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Afaya A, Yakong VN, Afaya RA, Salia SM, Adatara P, Kuug AK, Nyande FK. A Qualitative Study on Women's Experiences of Intrapartum Nursing Care at Tamale Teaching Hospital (TTH), Ghana. J Caring Sci 2017; 6:303-314. [PMID: 29302570 PMCID: PMC5747589 DOI: 10.15171/jcs.2017.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 09/01/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction: Labor and delivery process is an exciting, anxiety-provoking, but rewarding time for a woman and her family after successful delivery of a newborn. The intrapartum period is the time where mothers expect more care. Taking care of a mother through delivery with no side effects is the task of a professional midwife who is trained with the skill to take the responsibility of caring for mothers and babies. Therefore, the aim of this study was to explore mother's experiences regarding quality of intrapartum nursing/midwifery care. Methods: Focused ethnographic study was employed. Data were collected from May to June 2016 TTH, Ghana using semi structured interview guide. Purposive sampling was employed to recruit 20 participants. Eight individual interviews were conducted in the post natal ward after 48 hours of delivery, followed by three focus group discussions two weeks after delivery when mothers visited post natal clinic. Interviews lasted for about 30-45 minutes during each session. Data were analyzed using thematic analysis. Results: The average age of women were 29 years with ranging from 19-43 years. Participants' experiences of nursing/midwifery care during birth were influenced by reception and respect, provision of information, technical skill, providers' behavior, pain management and availability of nurses/midwives. Conclusion: The study findings have revealed that women's experience of care is affected by a wide range of determinants. Therefore, maternal health programs and policies in Ghana must take into account women's perspective on the care they need and their feedback on services they receive. Nursing education should re-enforce communication/relational skills.
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Affiliation(s)
- Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Vida N Yakong
- Department of Midwifery, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Richard A Afaya
- Department of Surgery, Tamale West Hospital, Northern Region, Ghana
| | - Solomon M Salia
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Peter Adatara
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Anthony K Kuug
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Flex K Nyande
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Lindtjørn B, Mitiku D, Zidda Z, Yaya Y. Reducing Maternal Deaths in Ethiopia: Results of an Intervention Programme in Southwest Ethiopia. PLoS One 2017; 12:e0169304. [PMID: 28046036 PMCID: PMC5207510 DOI: 10.1371/journal.pone.0169304] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 12/14/2016] [Indexed: 11/18/2022] Open
Abstract
Background In a large population in Southwest Ethiopia (population 700,000), we carried out a complex set of interventions with the aim of reducing maternal mortality. This study evaluated the effects of several coordinated interventions to help improve effective coverage and reduce maternal deaths. Together with the Ministry of Health in Ethiopia, we designed a project to strengthen the health-care system. A particular emphasis was given to upgrade existing institutions so that they could carry out Basic (BEmOC) and Comprehensive Emergency Obstetric Care (CEmOC). Health institutions were upgraded by training non-clinical physicians and midwives by providing the institutions with essential and basic equipment, and by regular monitoring and supervision by staff competent in emergency obstetric work. Results In this implementation study, the maternal mortality ratio (MMR) was the primary outcome. The study was carried out from 2010 to 2013 in three districts, and we registered 38,312 births. The MMR declined by 64% during the intervention period from 477 to 219 deaths per 100,000 live births (OR 0.46; 95% CI 0.24–0.88). The decline in MMR was higher for the districts with CEmOC, while the mean number of antenatal visits for each woman was 2.6 (Inter Quartile Range 2–4). The percentage of pregnant women who attended four or more antenatal controls increased by 20%, with the number of women who delivered at home declining by 10.5% (P<0.001). Similarly, the number of deliveries at health posts, health centres and hospitals increased, and we observed a decline in the use of traditional birth attendants. Households living near to all-weather roads had lower maternal mortality rates (MMR 220) compared with households without roads (MMR 598; OR 2.72 (95% CI 1.61–4.61)). Conclusions Our results show that it is possible to achieve substantial reductions in maternal mortality rates over a short period of time if the effective coverage of well-known interventions is implemented.
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Affiliation(s)
- Bernt Lindtjørn
- Centre for International Health, University of Bergen, Bergen, Norway
- * E-mail:
| | | | | | - Yaliso Yaya
- Centre for International Health, University of Bergen, Bergen, Norway
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