Abstract
BackgroundClient 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.MethodsA 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.ResultsMost 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.ConclusionChildbirth 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.
Highlights
Client satisfaction is an essential component of quality of care
Patient satisfaction is a key part of quality of care [3] and, the multidimensional aspects of quality of care provision are increasingly highlighted, as indicated in the World Health Organization’s (WHO) quality of care framework [4], which builds on the landmark article written by Donabedian [5]
Overall, 4441 mothers were identified from the Community Level Interventions for Pre-eclampsia (CLIP) trial as having given birth during the 12 months before the start of the study, of which 83 (1.9%) were not interviewed because they were not found at home (65 mothers) or refused to answer (18 mothers), giving a response rate of 98.1%
Summary
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. Patient satisfaction is a key part of quality of care [3] and, the multidimensional aspects of quality of care provision are increasingly highlighted, as indicated in the World Health Organization’s (WHO) quality of care framework [4], which builds on the landmark article written by Donabedian [5]. These aspects include the need to address several of the underlying reasons for high mortality and insufficient care, which account for the prevailing unsatisfactory outcomes despite increases in uptake of care [4]. Statements and initiatives have been formulated to reduce incidences of unacceptable treatment of women during pregnancy and childbirth [7,8,9,10]
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