Perception of mothers and providers on the quality of care in maternal and newborn service in selected hospitals of Addis Ababa

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Addis Abeba Universty


Introduction One of the most important ways to address some of the key factor associated with both maternal and neonatal mortality is assuring emergency obstetric and neonatal care with maximum quality of care at the time of labour, delivery and immediate after birth. However, improved quality outcomes are not delivered by health service providers alone communities and service users are the co-producers of health. Therefore, mothers have critical roles and responsibilities in identifying their own needs and preferences. Objectives: - To assess mothers‟ and provider‟s perception on the quality of maternal and newborn care and associated factors during the time of labour, delivery and immediately after birth in the selected hospitals of Addis Ababa. Methodology: - Institution based cross sectional quantitative and qualitative study design was conducted. For quantitative part of the study, multistage stratified sampling technique was used to reach sample size of 633. Pretested structured questioner was used as the main tools for data collection from March to April 2016. Data coding and checking were done by using EpI Info version 7 and imported to STATA 12 for cleaning and analysis. To determine factors associated with perceived quality bivariate and multivariate logistic regression were applied at 95% CI and p value<0.05. For qualitative study focused group discussion was chosen as a tool for data collection the participant were purposely selected from the study hospitals four FGD were conducted (two from private, two from government hospitals). Finally, thematic analysis was used to generate themes. Result Five hundred seventy-six delivering mothers were included with 90.9% response rate. One hundred sixty four (28.4%) of the mothers get delivery service in private hospital and four hundred twelve 412(71.52%) in government hospital. 59.38% of the mothers were delivered by caesarian section while the rest (40.63%) were delivered vaginaly and assisted delivery. Only 8.33% of the mothers outcome were with complication and 2.78% of the newborns outcome were death (stillbirth and early neonatal death). About 259(51.22%) of the mothers score the overall quality above the mean score of 83.3 with SD±10.4. Perceived satisfaction score of the mothers were 46.01%. Health provider‟s respect, comfortable labour and delivery room, active labour follow up and confidence and competency of health providers were predictors for mothers‟ perceived high quality in the process of care(p<0.05). Adequacy of health providers, adequacy of room and bed, availability of drugs and lab investigations in the health facility were a major structural predictors for mother‟s perceived quality(p<0.05). Mothers and newborn health out came were not significantly associated with mother‟s perceived quality. However, satisfaction of mothers with labour and delivery service was a strong predictor for mothers perceived quality (p<0.05). Conclusion This study shows that the overall mothers perceived quality of care at labour, delivery and immediately after delivery was satisfactory but still need improvement. All the three components of quality of care have an effect on perceived quality of care at labour delivery and immediately after birth therefore need special attention. The current quality of care is still behind the desired health care practice and outcome



Perception of mothers