How do Malawian women rate the quality of maternal and newborn care? Experiences and perceptions of women in the central and southern regions

BMC Pregnancy and Childbirth

Malabika Sarker⁴  Adamson S. Muula²  Manuela De Allegri³  Stephan Brenner³  Jacob Mazalale²  Julia Lohmann³  Christabel Kambala¹ 

[1] Environmental Health Department, The Malawi Polytechnic, University of Malawi, Blantyre, Malawi;School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi;Institute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany;James P. Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh

关键词: Women’s health;    Maternal and newborn;    Perceived quality of care;   

Others  :  1222881
DOI  :  10.1186/s12884-015-0560-x

 received in 2014-05-13, accepted in 2015-05-18,  发布年份 2015

【 摘 要 】

Background

While perceived quality of care is now widely recognized to influence health service utilization, limited research has been conducted to explore and measure perceived quality of care using quantitative tools. Our objective was to measure women’s perceived quality of maternal and newborn care using a composite scale and to identify individual and service delivery factors associated with such perceptions in Malawi.

Methods

We conducted a cross-sectional survey in selected health facilities from March to May 2013. Exit interviews were conducted with 821 women convenience sampled at antenatal, delivery, and postnatal clinics using structured questionnaires. Experiences and the corresponding perceived quality of care were measured using a composite perception scale based on 27 items, clustered around three dimensions of care: interpersonal relations, conditions of the consultation and delivery rooms, and nursing care services. Statements reflecting the 27 items were read aloud and the women were asked to rate the quality of care received on a visual scale of 1 to 10 (10 being the highest score). For each dimension, an aggregate score was calculated using the un-weighted item means, representing three outcome variables. Descriptive statistics were used to display distribution of explanatory variables and one-way analysis of variance was used to analyse bivariate associations between the explanatory and the outcome variables.

Results

A high perceived quality of care rating was observed on interpersonal relations, conditions of the examination rooms and nursing care services with an overall mean score of 9/10. Self-introduction by the health worker, explanation of examination procedures, consent seeking, encouragement to ask questions, confidentiality protection and being offered to have a guardian during delivery were associated with a high quality rating of interpersonal relations for antenatal and delivery care services. Being literate, never experienced a still birth and, first ANC visit were associated with a high quality rating of room conditions for antenatal care service.

Conclusions

The study highlights some of the multiple factors associated with perceived quality of care. We conclude that proper interventions or practices and policies should consider these factors when making quality improvements.

【 授权许可】

   
2015 Kambala et al.

【 图 表 】

Fig. 1.

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