Perceptions of Pregnant Women on the Quality of Maternal and Child Health Services Offered at Selected Health Facilities in Zimbabwe
Introduction: Assessing patients’
perceptions on the quality of health services they receive is an integral part
of health service quality management strategies and an important vehicle for
improving health services. Zimbabwe has limited data on patients’ perceptions
of the quality of maternal and child health services.
Methodology: An analytic cross-sectional study was conducted to determine perceptions
of pregnant women attending antenatal care (ANC) on the quality of maternal and
child health services at 21 health facilities in 2 out of the 10 provinces. Exit interviews with 190 pregnant women
were conducted using a semi-structured questionnaire. Data were analysed using Epi Info,
generating measures of central tendency, proportions, bivariate and
Results: A majority (84.8%) of participants were satisfied
with maternal and child health services. Participants
who reported having been given a pleasant welcome [COR=3.37 (1.92 – 5.90)],
given clear instructions on how to take medication [COR=2.11 (1.03 – 3.91)],
and treated with respect [COR=4.14 (2.37 – 7.33)] were more likely to be
satisfied with health services. Patients who visited several departments to get
health services were less likely to be satisfied [COR=0.38 (0.19 - 0.67)]. Independent determinants of satisfaction /
dissatisfaction include being given a pleasant and warm welcome (AOR=1.38,
p=0.01), being treated with respect (AOR=2.14, p=0.03) and visiting several
departments to get health services (AOR=0.47, p=0.04).
Discussion: Although a majority of participants reported satisfaction
with quality of maternal and child health services, there is room for
improvement especially patients’ clinical consultation process and integration
of health services.
Keywords: Satisfaction, maternal, child, health services,
National Health Strategy, 2016-2020.
Demographic and Health Survey, 2015.
Indicators Cluster Survey, 2014.
Population Based HIV Impact Assessment, 2015-2016.
Ministry of Health and Child Care 2015 HIV Estimates.
Strategic Plan for Elimination of new HIV infections in Children and keeping
mothers and families alive, Zimbabwe Ministry of Health and Child Care: 2011 -
. Epstein A.
Sounding board: the outcomes movement, will it get us where we want to go? New
England Journal of Medicine, 1990, 323 (4): 266–269.
. Blumenfeld SN.
Quality assurance in transition. Papua New Guinea Medical Journal, 1993, 36
(2): 8 Fisher AW. Patient’s evaluation of outpatient medical care. Journal of
Medical Education, 1971, 46 (3): 238–244.
. Smith WA. Consumer
demand and satisfaction. The hidden key to successful privatization.
Washington, DC, Academy for Educational Development, Health Com, Communication
for Child Survival, 1989.
. De Geydnt W.
Managing the quality of health care in developing countries. Washington, DC,
The World Bank, 1995.
. Fitzpatrick R,
Hopkins A. Problems in the conceptual framework of patient satisfaction
research: an empirical exploration. Social Health Illness 1983: 5 297-311.
. Jenkinson C,
Coulter A, Bruster S. The Picker Experience Questionnaire: development and
validation using data from inpatient surveys in five countries. International
Journal for Quality in Health Care 2002 14 (5) 353-358.
. Carr-Hill R. A.
The measurement of Patient Satisfaction. Journal of Public Health Medicine
1992, 14 (3) 236-249.
. The Picker
Institute 2004 The Picker Surveys – our method for understanding the patient
. Commission for
Health Improvement; NHS UK Patient Experience. Dimensions, Definitions and
Clinical Governance Review Codes http://www.chi.nhs.uk/patients/methods_app1.pdf
viewed 19th December 2004.
. Howard, John A. and J.N. Sheth. The theory
of buyer behaviour. New York: John Wiley and Sons,P,145 1969.
. Gerteis M,
Edgman-Levitan S, Daley J, Delbanco T: Through the Patient's Eyes:
Understanding and Promoting Patient-Centered Care. San Francisco: Jossey.
. Birna A. The
quality of hospital services in eastern Ethiopia: Patient's perspective. Ethiop
J Health Dev. 2006;20.199–200.
Bernard Kofi. 1996. “The effect of user fees on the quality of rural health
services. (A case study from Tororo, Uganda).” University of Heidelberg.
Institute of Tropical Hygiene and Public Health.
. Camphel C, Scott K, Madanhire C, Nyamukapa
C, Gregson C. A “good hospital”: Nurse and patient perception on good clinical care for
HIV positive people on Antiretroviral therapy in rural Zimbabwe – A
mixed-methods qualitative study. Int J. Nur Stu. Feb 2011; 48(2-3): 175-183.
. Davies AR, Ware
JE. Involving consumers in quality of care. Health Aff. 1988;33– 48. http://dx.doi.org/10.1377/hlthaff
. Dish Project in Four Selected Districts,
Uganda. 1999. “Quality of Reproductive Healthcare Study.” Delivery of Improved
Services for Health.