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How do Malawian women rate the quality of maternal and newborn care? Experiences and perceptions of women in the central and southern regions.

Kambala C, Lohmann J, Mazalale J, Brenner S, De Allegri M, Muula AS, Sarker M - BMC Pregnancy Childbirth (2015)

Bottom Line: Self-introduction by the health worker, explanation of examination procedures, consent seeking, encouragement to ask questions, confidentiality protection and being offered to have a guardian during delivery were associated with a high quality rating of interpersonal relations for antenatal and delivery care services.The study highlights some of the multiple factors associated with perceived quality of care.We conclude that proper interventions or practices and policies should consider these factors when making quality improvements.

View Article: PubMed Central - PubMed

Affiliation: Institute of Public Health, Faculty of Medicine, University of Heidelberg, INF 324, Heidelberg, Germany. christabel_kambala@yahoo.com.

ABSTRACT

Background: While perceived quality of care is now widely recognized to influence health service utilization, limited research has been conducted to explore and measure perceived quality of care using quantitative tools. Our objective was to measure women's perceived quality of maternal and newborn care using a composite scale and to identify individual and service delivery factors associated with such perceptions in Malawi.

Methods: We conducted a cross-sectional survey in selected health facilities from March to May 2013. Exit interviews were conducted with 821 women convenience sampled at antenatal, delivery, and postnatal clinics using structured questionnaires. Experiences and the corresponding perceived quality of care were measured using a composite perception scale based on 27 items, clustered around three dimensions of care: interpersonal relations, conditions of the consultation and delivery rooms, and nursing care services. Statements reflecting the 27 items were read aloud and the women were asked to rate the quality of care received on a visual scale of 1 to 10 (10 being the highest score). For each dimension, an aggregate score was calculated using the un-weighted item means, representing three outcome variables. Descriptive statistics were used to display distribution of explanatory variables and one-way analysis of variance was used to analyse bivariate associations between the explanatory and the outcome variables.

Results: A high perceived quality of care rating was observed on interpersonal relations, conditions of the examination rooms and nursing care services with an overall mean score of 9/10. Self-introduction by the health worker, explanation of examination procedures, consent seeking, encouragement to ask questions, confidentiality protection and being offered to have a guardian during delivery were associated with a high quality rating of interpersonal relations for antenatal and delivery care services. Being literate, never experienced a still birth and, first ANC visit were associated with a high quality rating of room conditions for antenatal care service.

Conclusions: The study highlights some of the multiple factors associated with perceived quality of care. We conclude that proper interventions or practices and policies should consider these factors when making quality improvements.

No MeSH data available.


Related in: MedlinePlus

Schutte Scale for rating the perceived quality of care
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Fig1: Schutte Scale for rating the perceived quality of care

Mentions: To ease data collection among a population of primarily illiterate women, we used a hand-held rating scaling instrument which has tabulation from 1 to 10 on one side and circular patterns on the other (see Fig. 1). The densely populated dark coloured circles correspond to 10 on the tabulated side, and the densely populated light coloured circles corresponded to 1. During the interview, the participant held the scale in a way that the tabulated side faced the enumerator while the patterned side faced the participant. After each statement was read out by the enumerator, the participant would respond by matching the location of the pointer to her level of agreement or disagreement with the statement. The enumerator would then record the corresponding numerical value. The measurement instrument and the technique were adapted from De Wet Schutte who developed it for use in the assessment of priorities when identifying community needs in development projects [35].Fig. 1


How do Malawian women rate the quality of maternal and newborn care? Experiences and perceptions of women in the central and southern regions.

Kambala C, Lohmann J, Mazalale J, Brenner S, De Allegri M, Muula AS, Sarker M - BMC Pregnancy Childbirth (2015)

Schutte Scale for rating the perceived quality of care
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4537589&req=5

Fig1: Schutte Scale for rating the perceived quality of care
Mentions: To ease data collection among a population of primarily illiterate women, we used a hand-held rating scaling instrument which has tabulation from 1 to 10 on one side and circular patterns on the other (see Fig. 1). The densely populated dark coloured circles correspond to 10 on the tabulated side, and the densely populated light coloured circles corresponded to 1. During the interview, the participant held the scale in a way that the tabulated side faced the enumerator while the patterned side faced the participant. After each statement was read out by the enumerator, the participant would respond by matching the location of the pointer to her level of agreement or disagreement with the statement. The enumerator would then record the corresponding numerical value. The measurement instrument and the technique were adapted from De Wet Schutte who developed it for use in the assessment of priorities when identifying community needs in development projects [35].Fig. 1

Bottom Line: Self-introduction by the health worker, explanation of examination procedures, consent seeking, encouragement to ask questions, confidentiality protection and being offered to have a guardian during delivery were associated with a high quality rating of interpersonal relations for antenatal and delivery care services.The study highlights some of the multiple factors associated with perceived quality of care.We conclude that proper interventions or practices and policies should consider these factors when making quality improvements.

View Article: PubMed Central - PubMed

Affiliation: Institute of Public Health, Faculty of Medicine, University of Heidelberg, INF 324, Heidelberg, Germany. christabel_kambala@yahoo.com.

ABSTRACT

Background: While perceived quality of care is now widely recognized to influence health service utilization, limited research has been conducted to explore and measure perceived quality of care using quantitative tools. Our objective was to measure women's perceived quality of maternal and newborn care using a composite scale and to identify individual and service delivery factors associated with such perceptions in Malawi.

Methods: We conducted a cross-sectional survey in selected health facilities from March to May 2013. Exit interviews were conducted with 821 women convenience sampled at antenatal, delivery, and postnatal clinics using structured questionnaires. Experiences and the corresponding perceived quality of care were measured using a composite perception scale based on 27 items, clustered around three dimensions of care: interpersonal relations, conditions of the consultation and delivery rooms, and nursing care services. Statements reflecting the 27 items were read aloud and the women were asked to rate the quality of care received on a visual scale of 1 to 10 (10 being the highest score). For each dimension, an aggregate score was calculated using the un-weighted item means, representing three outcome variables. Descriptive statistics were used to display distribution of explanatory variables and one-way analysis of variance was used to analyse bivariate associations between the explanatory and the outcome variables.

Results: A high perceived quality of care rating was observed on interpersonal relations, conditions of the examination rooms and nursing care services with an overall mean score of 9/10. Self-introduction by the health worker, explanation of examination procedures, consent seeking, encouragement to ask questions, confidentiality protection and being offered to have a guardian during delivery were associated with a high quality rating of interpersonal relations for antenatal and delivery care services. Being literate, never experienced a still birth and, first ANC visit were associated with a high quality rating of room conditions for antenatal care service.

Conclusions: The study highlights some of the multiple factors associated with perceived quality of care. We conclude that proper interventions or practices and policies should consider these factors when making quality improvements.

No MeSH data available.


Related in: MedlinePlus