Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia
Abstract Background Antenatal healthcare (ANC) reduces maternal and neonatal deaths in low-middle-income countries. Satisfaction with ANC services and perception of quality of care are critical determinants of service utilization. The study aimed to assess pregnant women’s satisfaction with ANC and...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-06181-5 |
| _version_ | 1827388048537550848 |
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| author | Ladislas Hibusu Joshua Sumankuuro Netsai Bianca Gwelo Olagoke Akintola |
| author_facet | Ladislas Hibusu Joshua Sumankuuro Netsai Bianca Gwelo Olagoke Akintola |
| author_sort | Ladislas Hibusu |
| collection | DOAJ |
| description | Abstract Background Antenatal healthcare (ANC) reduces maternal and neonatal deaths in low-middle-income countries. Satisfaction with ANC services and perception of quality of care are critical determinants of service utilization. The study aimed to assess pregnant women’s satisfaction with ANC and identify sociodemographic factors associated with satisfaction and their continued willingness to use or recommend the facility to relatives or friends, in Lusaka district, Zambia. Methods This was a cross-sectional study involving 499 pregnant women in Lusaka district. A combination of stratified, multistage, and systematic sampling procedures was used in selecting health facilities and pregnant women. This allowed the researcher to assess exposure and status simultaneously among individuals of interest in a population. Structured survey instruments and face-face-interview techniques were used in collecting data among pregnant women who were receiving ANC in selected health facilities. Results Overall, the proportion of pregnant women who were fully satisfied with ANC was 58.9% (n = 292). Pregnant women’s satisfaction score ranged from physical aspects (40.9 - 58.3%), interpersonal aspects (54.3 - 57.9%) to technical aspects of care (46.9 - 58.7%). Husbands’ employment status (OR = 0.611, 95%CI = 0.413 – 0.903, p = 0.013), monthly household income level of > 3000 - ≤6000 Kwacha (OR = 0.480, 95%CI = 0.243 – 0.948, p = 0.035 were significantly associated with the interpersonal aspects and the physical aspects of care, respectively. Besides, pregnant women who were in their third trimester (above 33 weeks), significantly predicted satisfaction with the physical environment of antenatal care (OR = 3.932, 95%CI = 1.349 – 11.466, p = 0.012). In terms of the type of health facility, women who utilized ANC from Mtendere (OR = 0.236, 95% CI = 0.093 – 0.595, p = 0.002) and N’gombe (OR = 0.179, 95% CI = 0.064 – 0.504, p = 0.001) clinics were less satisfied with the physical environment of care. Place of residence and educational attainment showed significant association with ‘willingness to return‘. N’gombe clinic (n = 48, 77.4%) received the lowest consideration for ‘future care’. Conclusion Drawing on Donabedian framework on assessing quality of healthcare, we posit that pregnant women’s satisfaction with the quality of antenatal care was low due to concerns about the physical environment of health facilities, the interpersonal relationships between providers and pregnant women as well as the technical aspects of care. All these accounted for pregnant women’s dissatisfaction with the quality of care, and the indication of unwillingness to return or recommend the health facilities to colleagues. Consistent with Donabedian framework, we suggest that the codes and ethics of healthcare must be upheld. We also call for policy initiatives to reshape the physical condition of ANC clinics and to reinforce healthcare providers’ focus on the ‘structures’ and the ‘processes’ relevant to care in addition to the ‘outcomes’. |
| first_indexed | 2024-03-08T16:12:08Z |
| format | Article |
| id | doaj.art-286592be17254f1d8bc7c41975fec470 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-08T16:12:08Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-286592be17254f1d8bc7c41975fec4702024-01-07T12:53:03ZengBMCBMC Pregnancy and Childbirth1471-23932024-01-0124111610.1186/s12884-023-06181-5Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, ZambiaLadislas Hibusu0Joshua Sumankuuro1Netsai Bianca Gwelo2Olagoke Akintola3School of Public Health, Faculty of Community and Health Sciences, University of the Western CapeSchool of Public Health, Faculty of Community and Health Sciences, University of the Western CapeSchool of Public Health, Faculty of Community and Health Sciences, University of the Western CapeSchool of Public Health, Faculty of Community and Health Sciences, University of the Western CapeAbstract Background Antenatal healthcare (ANC) reduces maternal and neonatal deaths in low-middle-income countries. Satisfaction with ANC services and perception of quality of care are critical determinants of service utilization. The study aimed to assess pregnant women’s satisfaction with ANC and identify sociodemographic factors associated with satisfaction and their continued willingness to use or recommend the facility to relatives or friends, in Lusaka district, Zambia. Methods This was a cross-sectional study involving 499 pregnant women in Lusaka district. A combination of stratified, multistage, and systematic sampling procedures was used in selecting health facilities and pregnant women. This allowed the researcher to assess exposure and status simultaneously among individuals of interest in a population. Structured survey instruments and face-face-interview techniques were used in collecting data among pregnant women who were receiving ANC in selected health facilities. Results Overall, the proportion of pregnant women who were fully satisfied with ANC was 58.9% (n = 292). Pregnant women’s satisfaction score ranged from physical aspects (40.9 - 58.3%), interpersonal aspects (54.3 - 57.9%) to technical aspects of care (46.9 - 58.7%). Husbands’ employment status (OR = 0.611, 95%CI = 0.413 – 0.903, p = 0.013), monthly household income level of > 3000 - ≤6000 Kwacha (OR = 0.480, 95%CI = 0.243 – 0.948, p = 0.035 were significantly associated with the interpersonal aspects and the physical aspects of care, respectively. Besides, pregnant women who were in their third trimester (above 33 weeks), significantly predicted satisfaction with the physical environment of antenatal care (OR = 3.932, 95%CI = 1.349 – 11.466, p = 0.012). In terms of the type of health facility, women who utilized ANC from Mtendere (OR = 0.236, 95% CI = 0.093 – 0.595, p = 0.002) and N’gombe (OR = 0.179, 95% CI = 0.064 – 0.504, p = 0.001) clinics were less satisfied with the physical environment of care. Place of residence and educational attainment showed significant association with ‘willingness to return‘. N’gombe clinic (n = 48, 77.4%) received the lowest consideration for ‘future care’. Conclusion Drawing on Donabedian framework on assessing quality of healthcare, we posit that pregnant women’s satisfaction with the quality of antenatal care was low due to concerns about the physical environment of health facilities, the interpersonal relationships between providers and pregnant women as well as the technical aspects of care. All these accounted for pregnant women’s dissatisfaction with the quality of care, and the indication of unwillingness to return or recommend the health facilities to colleagues. Consistent with Donabedian framework, we suggest that the codes and ethics of healthcare must be upheld. We also call for policy initiatives to reshape the physical condition of ANC clinics and to reinforce healthcare providers’ focus on the ‘structures’ and the ‘processes’ relevant to care in addition to the ‘outcomes’.https://doi.org/10.1186/s12884-023-06181-5Maternal health servicesAntenatal carePatient satisfaction, health care utilizationHealthcare acceptabilityZambia |
| spellingShingle | Ladislas Hibusu Joshua Sumankuuro Netsai Bianca Gwelo Olagoke Akintola Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia BMC Pregnancy and Childbirth Maternal health services Antenatal care Patient satisfaction, health care utilization Healthcare acceptability Zambia |
| title | Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia |
| title_full | Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia |
| title_fullStr | Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia |
| title_full_unstemmed | Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia |
| title_short | Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia |
| title_sort | pregnant women s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in lusaka district zambia |
| topic | Maternal health services Antenatal care Patient satisfaction, health care utilization Healthcare acceptability Zambia |
| url | https://doi.org/10.1186/s12884-023-06181-5 |
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