Abstract
BackgroundMajority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes.MethodsA cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. The questionnaire contained 23 items distributed under three main domains: technical and information domain, interpersonal care domain and ward facilities and cleanliness domain. Each item was given a score from 1 to 5 and total scores were calculated for the total questionnaire and for each domain. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions.ResultsThe median score obtained for the questionnaire was 108, (Inter Quartile Range 96–114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (IQR 38–45), 33 (IQR 30–35) and 32 (IQR 28–35) respectively. Attending teaching/ specialized hospitals (aOR=1.6, p < 0.001), 20–35 age group (1.8, p = 0.024), and services such as initiation of breast feeding within 1 h of delivery (2.1, p = 0.009), pain relief during episiotomy suturing (2.2, p < 0.001), practicing Kangaroo Mother Care (1.4, p = 0.035), receiving health advices by doctors or midwives (2.1, p < 0.001) were significant correlates of positive perceptions.ConclusionsMajority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data.
Highlights
Majority of the maternal and neonatal adverse events take place during the postnatal period
A new instrument - The Client Perceived Quality of Institutional Postnatal Care (CPQIPNC) questionnaire- was developed by the Principal Investigator (PI), for data collection
The current study found that certain services, such as initiation of breast feeding within 1 h of delivery, pain relief during suturing of the episiotomy, ability to practice kangaroo mother care (KMC), receiving health advices by the doctors and midwives were associated with higher ratings of quality of care provided to mothers and the babies
Summary
Majority of the maternal and neonatal adverse events take place during the postnatal period. The first few weeks following the delivery of a baby is a crucial period for both mother and the newborn as a majority of maternal and newborn adverse outcomes takes place in this period [1,2,3]. Quality of health care is considered an essential component of health services [6] It ensures that services are effective, efficient, patient centered, cost effective and safe [4]. Client perceived quality is defined as “subjective and dynamic perception of the extent to which expected health care is received by a person” [11]. It provides health workers and authorities with valuable information to improve the service quality and render it patient-centered. It is known that unsatisfied clients may not return to the same facility even during an emergency and even if the facility provides state of the art care [6, 10]
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