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      Mothers' satisfaction with referral hospital delivery service in Amhara Region, Ethiopia

      research-article
      1 , 2 , , 2
      BMC Pregnancy and Childbirth
      BioMed Central

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          Abstract

          Background

          A woman's satisfaction with the delivery service may have immediate and long-term effects on her health and subsequent utilization of the services. Providing satisfying delivery care increases service utilization. The objective of this study is to assess the satisfaction of mothers with referral hospitals' delivery service and identify some possible factors affecting satisfaction in Amhara region of Ethiopia.

          Methods

          A hospital-based cross-sectional survey that involved an exit interview was conducted from September to November 2009 in three referral hospitals in Ethiopia. A total of 417 delivering mothers were enrolled in the study. Client satisfaction was measured using a survey instrument adopted from the Donabedian quality assessment framework. We collect data systematically from every other postnatal woman who delivered in the referral hospitals. Multivariate and binary logistic regression was applied to identify the relative effect of each explanatory variable on the outcome (satisfaction).

          Results

          The proportion of mothers who were satisfied with delivery care in this study was 61.9%. Women's satisfaction with delivery care was associated with wanted status of the pregnancy, immediate maternal condition after delivery, waiting time to see the health worker, availability of waiting area, care providers' measure taken to assure privacy during examinations, and amount of cost paid for service.

          Conclusions

          The overall satisfaction of hospital delivery services in this study is found to be suboptimal. The study strongly suggests that more could be done to assure that services provided are more patient centered.

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          Most cited references7

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          Factors related to childbirth satisfaction.

          A woman's satisfaction with the childbirth experience may have immediate and long-term effects on her health and her relationship with her infant, but there is a lack of current research in this area. This paper reports a study to examine multiple factors for their association with components of childbirth satisfaction and with the total childbirth experience. A correlational descriptive study was conducted with 60 low-risk postpartum women, aged 18-46 years, with uneventful vaginal deliveries of healthy full-term infants at two medical centres in the south-eastern United States. The Labor Agentry Scale, McGill Pain Questionnaire and Mackey Childbirth Satisfaction Rating Scale and a background questionnaire were completed by women. Obstetrical data were collected from the medical record. Personal control was a statistically significant predictor of total childbirth satisfaction (P = 0.0045) and with the subscale components of satisfaction (self, partner, baby, nurse, physician and overall). In addition, having expectations for labour and delivery met was a significant predictor of satisfaction with own performance during childbirth. Personal control during childbirth was an important factor related to the women's satisfaction with the childbirth experience. Helping women to increase their personal control during labour and birth may increase the women's childbirth satisfaction.
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            Just another day in a woman's life? Part II: Nature and consistency of women's long-term memories of their first birth experiences.

            P Simkin (1992)
            Twenty women who attended the author's natural childbirth classes between 1968 and 1974 were the informants in this study of long-term memories of their first childbirths. The data from each informant consisted of 1) a labor and birth questionnaire, including an open-ended account of her labor, written shortly after her baby was born; 2) a similar questionnaire and account written in 1988 and 1989; and 3) a transcribed interview during which her memories and perceptions were discussed and any discrepancies between the questionnaires were explored. The questionnaires were compared for consistency of recall, and the interviews consulted for further clarification. Specific memories were excerpted, compared, classified, tabulated, and summarized. Findings were that, years later, women's memories are generally accurate, and many are strikingly vivid, especially of onset of labor; rupture of the membranes; arrival at the hospital; actions of doctors, nurses, and partners; particular interventions; the birth; and first contact with the baby. Most memory lapses or confusion were minor. Evidence of a halo effect was observed as well.
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              Women's satisfaction with delivery care in Nairobi's informal settlements.

              To quantify women's satisfaction with delivery care in informal settlements of Nairobi, Kenya, and to determine characteristics of women and delivery care associated with satisfaction. Household survey data analysis of 1266 women who delivered in health facilities in 2004 or 2005. Two densely populated informal settlements 7 and 12 km from Nairobi's center, where residents work primarily in the nearby industrial area or in the informal sector. Outcome Satisfaction was assessed by whether women would recommend the delivery care facility and deliver there again. Over half (56%) of women would both recommend and deliver again in the same facility. In multivariate analysis, women's satisfaction with delivery care was associated with greater provider empathy (OR = 3.68, 95% CI 2.27, 5.97). Women's satisfaction with delivery care was also associated with the pregnancy having been wanted (OR = 2.75, 95% CI 1.82, 4.14) or mistimed vs. unwanted. Women delivering at private facilities in the settlement near the industrial area were more satisfied than women delivering at private facilities in the more distant and marginalized settlement (OR = 2.12, 95% CI 1.45, 3.09). The association of women's satisfaction and provider empathy was stronger among women who experienced complications compared to those who did not. Health providers should be sensitized to the finding that unintended pregnancy is associated with lower satisfaction with delivery care. Maternal health programmes should focus on increasing provider empathy, especially for women who experience complications, in both private and government health facilities.
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                Author and article information

                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central
                1471-2393
                2011
                24 October 2011
                : 11
                : 78
                Affiliations
                [1 ]Department of Public Health, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
                [2 ]Department of Epidemiology and Biostatistics, University of Gondar, P.O.Box 196, Gondar, Ethiopia
                Article
                1471-2393-11-78
                10.1186/1471-2393-11-78
                3254067
                22023913
                a18fd3de-d485-4aaa-a74b-f7c4bc0148bd
                Copyright ©2011 Tayelgn et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 March 2011
                : 24 October 2011
                Categories
                Research Article

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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