Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women’s satisfaction with maternity care in developing countries. The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction.

https://link.springer.com/content/pdf/10.1186%2Fs12884-015-0525-0.pdf

Determinants of women’s satisfaction with maternal health care: a review of literature from developing countries

Maternal mortality and morbidity are attributed to poor maternity quality of care.1 globally; more than half a million women die annually as a result of complications of pregnancy and childbirth. Despite the effort and substantial amount of resources spent to reduce maternal mortality; every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. Ninety-nine percent of these deaths occur in most developing countries like Ethiopia.2 Rates of maternal mortality are 19 times higher in developing countries than in developed. In the African Region, however, the MMR is still running at 540 per 100, 000 live births, which, combined with the high levels of fertility, translates into a lifetime risk of dying from maternal causes of 1 in 37.3 The current global MMR of 216 per 100, 000. The world’s MMR fell by 44% between 1990 and 2015, missing the target of a 75% reduction and In 2015, the African Region accounts for 64% of maternal deaths.3

/pdf/mothers-satisfaction-with-delivery-services-and-associated-2hcp6nnsbb.pdf

Mothers’ satisfaction with delivery services and associated factors at health institutions in west Arsi, Oromia regional state, Ethiopia

Evidence of variation in maternity health service practices has increased the government’s interest in quantifying and advancing the quality of institutional delivery care in the developing world, including Ethiopia. Therefore, we conducted a systematic review and meta-analysis to update and provide more representative data on women’s satisfaction with skilled delivery care and the associated factors in Ethiopia. This systematic review and meta-analysis followed the Preferred Reporting Items 2015 guideline. We searched PubMed/Medline, SCOPUS, Embase, Web of Science, and Google Scholar electronic databases for all 36 included studies. The pooled prevalence of women’s satisfaction with skilled delivery care and the associated factors were estimated using a random-effects model. Subgroup analysis and meta-regression were performed to identify the source of heterogeneity. Furthermore, publication bias was checked using eggers and funnel plots. All statistical analyses were performed using STATA version 14.0 software. The pooled prevalence of women’s satisfaction with skilled delivery care was 67.31 with 95% confidence interval (60.18–74.44). Wanted pregnancy (adjusted odds ratio = 2.86, 95% confidence interval: (2.24–3.64)), having a plan to deliver at a health facility (adjusted odds ratio = 2.09, 95% confidence interval: (1.42–3.09)), access to ambulance service (adjusted odds ratio = 1.52, 95% confidence interval: (1.00–2.31)), waiting time < 15 min (adjusted odds ratio = 3.66, 95% confidence interval: (2.51–5.33)), privacy assured (adjusted odds ratio = 3.94, 95% confidence interval: (2.23–6.94)), short duration of labour < 12 hr (adjusted odds ratio = 2.55, 95% confidence interval: (1.58–4.12)), proper labour pain management (adjusted odds ratio = 3.01, 95% confidence interval: (1.46–6.22)), and normal newborn outcome (adjusted odds ratio = 3.94, 95% confidence interval: (2.17–7.15)) were associated with women’s satisfaction. Almost two-thirds of women were satisfied with skilled delivery care. In comparison, the remaining one-third were not satisfied with the care. The quality of intrapartum care, unwanted pregnancy, lack of ambulance services, prolonged duration of labour, poor labour pain management, and complicated newborn outcome were factors affecting women’s satisfaction with skilled delivery care in Ethiopia. Therefore, strategies need to be developed to increase the satisfaction level by considering the abovementioned factors during routine delivery care.

A systematic review and meta-analysis of women’s satisfaction with skilled delivery care and the associated factors in Ethiopia

Objective: This study was performed to determine the level of satisfaction among women attending the prenatal clinics in the city of Zanjan, Iran. Materials and methods: This descriptive cross- sectional study was performed from 2005 to 2006 in Zanjan. A total of 701 pregnant women with gestational age of 20 weeks or more who had undergone at least two prenatal visits in prenatal care centers were enrolled into the study. A questionnaire was filled by face to face interview with each mother including questions about the general physical environment of the clinic, whether the pregnancy wassolicited, the communication skills of the personnel, the quality, feasibility and costof prenatal care, as well as questions pertaining to demography and type of insurance. Data were entered into SPSS 11 software and subsequently analyzed using descriptive statistical tests including ANOVA. Results: Mean age of mothers was 26.23 ± 5.6 years. Among them 55.8%, 37.3% and 6.9% had up to primary, secondary, and high school level of education, respectively. Overall satisfaction rate was more than 99% in all aspects and dissatisfaction was mainly related to type of insurance. The dissatisfaction was alsorelated to the trainings given in health center. Women with private insurance (free and military) showed the least dissatisfaction while the highest dissatisfaction was in women with social security or health services insurance. Conclusion: Overall dissatisfaction rate was 1%. The dissatisfaction was related to the type of insurance. The dissatisfaction wasalso related to the level of the trainings given in health center.

/pdf/satisfaction-with-the-prenatal-clinics-in-zanjan-iran-dcr675tsfr.pdf

Satisfaction with the Prenatal Clinics in Zanjan, Iran

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Satisfaction with the Prenatal Clinics in Zanjan, Iran