Factors associated with maternal satisfaction of care during labour and delivery among women who delivered at Kisarawe hospital – costal region

Abstract

ABSTRACT Background: The World Health Organization (WHO) has emphasized that countries should monitor and evaluate maternal satisfaction in public health care sectors to improve the quality and efficiency of health care as well as a means of secondary prevention of maternal mortality. Despite of this international emphasis, researches in sub-Saharan African reported that women face discrepancies in care provided during labour and delivery which causes negative impacts to mother’s and neonate’s health and wellbeing. Aim of the study: Thisstudy assessedfactors associated with maternal satisfaction among women who delivered at Kisarawe hospital in Coastal Region-Tanzania. Methodology: A descriptive cross-sectional study design was conducted using a quantitative approach. A Likert scale questionnaire with closed ended questions adapted from Donabedian framework was used to collect data. The simple random sampling technique using a lottery method was used to obtain a sample size of 242 participants and they all agreed to participate in the study. Data were checked for completeness and consistence before leaving from the field and then processed, entered, coded and analyzed using the STATA software Version 12.

Frequency distributions and two way tables were used to summarize the dependent and independent variables. The questionnaire contained 52 items on Likert scale of different aspects of delivery care service. Women were considered to be satisfied if they reported satisfaction to at least above than 26 items assessed. Bivariate and Multivariate logistic regression analysis were used and Chie square and Fisher`s exact test were used to identify predictors for maternal satisfaction during labour and delivery

Results: The total of 242 participants was interviewed. The overall proportion of 71.1% of mothers was satisfied with care provided during labour and delivery. Proportion of mothers satisfied varied in different variables of care ranging from 36.4% reported to be satisfied with process of care provision to 95.5% reported to be satisfied with outcome of care provided. With regard to variable of process of care provision, the majority of respondents (78.5%) was not satisfied with theaspects in respectful maternity care, client-provider relationship (62.0%), information sharing (59.9%), emotional support (companionship) and perceived good care (57.0%). Furthermore, findings of this study revealed the couple of factors were associated with maternal satisfaction. Factors such as availability of bed sheets to every individual client all the time [AOR= 14.3, 95% CI (1.1-80.6)], providers taught about pain relieving methods [AOR= 10.2 95% CI(2.2-48.4)] , health care provider listened and answered client`s questions and concerns all the time [AOR= 17.6, 95%CI(2.6-19.4)], giving feedback about mother`s and fetal condition and progress of labour after every examination [AOR=26, 95% CI (3.9-73.7)] were strongly assdociated with maternal satisfaction of care during labour and delivery.

Conclussion:The finding have revealed high level of maternal satisfaction across the variables of outcome of care provided, accessibility of services and condition of physical facility;however, majority of respondents reported extremely high disatisfaction in the variable of the process of care provisionspecifically in aspects of respectful maternity care, client provider relation-ship, informational sharing, emotional support and perceived good care. Recommendations:The findings of this study have brought about recommendations in three different areas of policy, practice and for further research.

For practice: The special consideration needs to be focused on respectful maternity care, client-provider relationship, and information sharing during labour and delivery, and emotional support for laboring and delivering women.

For policy: The hospital system management (CHMT and HMT) needs to consider the aspects in which mothers were not satisfied so as to set plans and strategies to improve the level of maternal satisfaction as well as quality of services provided during labour and delivery at Kisarawe hospital.