Patient Perceptions of ANC Services Among the Women in Rajasthan

Abstract

Abstract Objectives Access to quality ante-natal care (ANC) during pregnancy can prevent a large number of risks at birth caused by low birthweight, prematurity, congenital abnormalities or asphyxia. Satisfaction with ANC services is an important yet neglected aspect of quality of care that could help to improve maternal and child health outcomes through better compliance and adoption of optimal health and nutrition practices during pregnancy. This study aims to assess women's perceived satisfaction with ANC services and its association with compliance behaviour during pregnancy. Methods We considered existing theoretical frameworks such as the Interaction Model of Client Health Behavior to design a Likert scale based self-assessment tool for satisfaction with a score ranging from 1 to 4. This tool was administered to 8583 mothers with children under three years of age across six districts of Rajasthan. Satisfaction with respect to the most recent pregnancy was assessed. We conducted exploratory factor analysis to construct the satisfaction scales for the respondents. Multivariate analysis was conducted to understand the association of satisfaction levels with key explanatory variables including caste, wealth, education, number of ANC visits, and iron and folic acid tablet consumption as a key indicator for compliance. Results Majority of the women were satisfied with the respectful treatment and support provided by the ANC providers. They reported being less satisfied with the individual attention they received. Information and treatment/referral provided by the health workers for management of infections was reported to be the least satisfying aspect of ANC. Further, satisfaction among beneficiaries was positively and significantly associated with the number of ANC visits and consumption of iron and folic acid tablets. Satisfaction with respect to health information provided was significantly higher for women with secondary level education and above, in comparison to illiterate women. Conclusions The ANC experience needs to be improved to provide individual attention to pregnant women and counsel them to manage and seek timely treatment for infections. Better satisfaction is likely to lead to better compliance and nutritional behaviour, thereby contributing to better mother and child health outcomes. Funding Sources Children's Investment Fund Foundation.