Assessment of Client-Health Care Provider Communication at Antenatal Care Clinics in Addis Ababa, Ethiopia
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Date
2012-06
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Addis Ababa University
Abstract
Background Health care provider-client communication during Antenatal care is an effective strategy to improve maternal health care seeking behavior and satisfaction with health services. However, the presence of miscommunication, lack of communication, or unsatisfactory communication between health care providers and clients pose a significant challenge in the health care service utilization.
Objective The aim of this study was to assess the client-health care provider communication including client satisfaction in public hospitals at antenatal care clinics, in Addis Ababa, Ethiopia.
Method: A cross-sectional study design using both quantitative and qualitative methods was employed from October to June 2012. 425 consecutive clients of antenatal care took part in the study. Additionally, in-depth interview was conducted among 15 purposively selected antenatal clients, 17 conveniently selected health care providers using interview guides.
Results: The mean (SD) age of antenatal clients was 27.6±4.7 years; majority having secondary (33.4%) and tertiary education (34.4%); and Only 161(37.9%) antenatal clients were satisfied by health care providers‟ quality of communication. Getting care by one provider at different visits (AOR=0.55;95%CI:0.32,0.96), longer duration of time for discussion(AOR=0.29;95%CI:0.11,0.77), clients‟ feeling of privacy(AOR=0.47;95%CI:0.22,0.99),health care providers‟ empathy (AOR=0.41; 95%CI:0.22,0.77) and information provision (AOR=0.09; 95% CI: 0.05, 0.17) were significantly associated with better client satisfaction. Time constraint due to heavy clients‟ load (88.0%), multiple clinical task (71.0%), and lack of dedicated space for communication (58.8%) were the most common barriers of optimal communication reported by health care providers.
Conclusion and Recommendation: more than 3 out of 5 of antenatal clients were not satisfied by the providers‟ quality of communication. Insufficient discussion time, suboptimal health care providers‟ empathy and information provision, lack of feeling of privacy and lack of continuity of care by same health care providers were the main factors that contributed to the low antenatal client satisfaction on health care provider‟s quality of communication.
Better demonstration of empathy, information provision, longer discussion time, continuity of care with one provider and providing sufficient feeling of privacy should be encouraged to improve antenatal clients‟ satisfaction on health care providers‟ quality of communication. Attempt should be made to free health care providers at ANC from multiple clinical tasks with more attention given to ensuring dedicated space to improve optimal provider-client communication.
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Health care provider-client communication