Advancing the health of women and newborns: predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda

Mutaganzwa, Christine; Wibecan, Leah; Iyer, Hari S.; Nahimana, Evrard; Manzi, Anatole; Biziyaremye, Francois; Nyishime, Merab; Nkikabahizi, Fulgence; Hirschhorn, Lisa R.; Magge, Hema

doi:10.1093/intqhc/mzy103

Cited by 15 publications

(18 citation statements)

References 25 publications

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“…Beyond clinical arguments for continuous support for women during childbirth [27, 64], the fact that having a companion improved mothers’ satisfaction, underlines the importance of allowing a person of choice to accompany them during birth. Consistent with findings from other studies [16, 43, 65], interpersonal relationships were important contributors to patient satisfaction. Mothers who had negative experiences during the process of care reported dissatisfaction more frequently than did those who had not had such experiences.…”

Section: Discussionsupporting

confidence: 90%

“…High levels of satisfaction with care during childbirth have been reported in other low- and middle-income countries, such as in Ethiopia, Egypt, Malawi, Philippines, and Rwanda [37–43], and in high-income countries, such as in Australia, England and Sweden [44–46]. It has been questioned whether these high scores are an accurate representation of the mothers’ experiences [12].…”

Section: Discussionmentioning

confidence: 99%

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Mothers’ satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique

Mocumbi

Högberg

Lampa

et al. 2019

BMC Pregnancy Childbirth

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Background Client satisfaction is an essential component of quality of care. Health system factors, processes of care as well as mothers’ characteristics influence the extent to which care meets the expectations of mothers and families. In our study, we specifically aimed to address the mothers’ experiences of, and satisfaction with, care during childbirth. Methods A population-based cross-sectional study, using structured interviews with published sequences of questions assessing satisfaction, including 4358 mothers who gave birth during the 12 months before June 2016 to estimate satisfaction with childbirth care. Regression analysis was used to determine the predictors of client satisfaction. Results Most mothers (92.5%) reported being satisfied with care during childbirth and would recommend that a family member to deliver at the same facility. Specifically, 94.7% were satisfied with the cleanliness of the facility, 92.0% reported being satisfied with the interaction with the healthcare providers, but only 49.8% felt satisfied with the assistance to feed their baby. Mothers who had negative experiences during the process of care, such as being abandoned when needing help, disrespect, humiliation, or physical abuse, reported low levels of satisfaction when compared to those who had not had such experiences (68.5% vs 93.5%). Additionally, they reported higher levels of dissatisfaction (20.1% vs 2.1%). Regression analysis revealed that mothers who gave birth in primary level facilities tended to be more satisfied than those who gave birth in hospitals, and having a companion increased, on average, the overall satisfaction score, with 0.06 in type II health centres (CI 0.03–0.10) and with 0.05 in type I health centres (CI − 0.02 – 0.13), compared to − 0.01(CI -0.08 – 0.07) in the hospitals, irrespective of age, education and socio-economic background. Conclusion Childbirth at the primary level facilities contributes to the level of satisfaction. The provision of childbirth care should consider women’s preferences and needs, including having a companion of choice. We highlight the challenge in balancing safety of care versus satisfaction with care and in developing policies on the optimum configuration of childbirth care. Interventions to improve the interaction with providers and the provision of respectful care are recommended. Electronic supplementary material The online version of this article (10.1186/s12884-019-2449-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Mothers’ satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique

Mocumbi

Högberg

Lampa

et al. 2019

BMC Pregnancy Childbirth

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“…Despite improved MNH quality of care and neonatal mortality, we found limited change in patient satisfaction. Mutaganzwa et al 19 described the baseline results in detail and found that patient-centeredness of care (including interpersonal relationships, respect, and privacy) and organizational factors such as cleanliness, comfort, and equipment/commodity availability were associated with higher satisfaction with care. Similar to other studies, one explanation for the lack of increased satisfaction corresponding with improved quality of care and outcomes could be that women were reluctant to share negative views or had low expectations of facility care and were satisfied with poor quality at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…Informed consent was obtained from women surveyed for patient satisfaction. 19 This study was approved by the Institutional Review Board of Brigham and Women’s Hospital (2009-P-001941/11; BWH) and the Rwanda National Ethics Committee (RNEC 032/RNEC/2012).…”

Section: Methodsmentioning

confidence: 99%

The All Babies Count Initiative: Impact of a Health System Improvement Approach on Neonatal Care and Outcomes in Rwanda

Magge

Nahimana

Mugunga

et al. 2020

Glob Health Sci Pract

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“…In addition, a better understanding of patient satisfaction with rural medical services and potential determinants would help policy- and decision-makers to implement programs better tailored to rural patients’ health needs and desires and further improve rural health systems [30,31]. Some evidence has been found about patient satisfaction with rural medical services in Italy [25], South Africa [26], India [32,33], Rwanda [34], Bangladesh [35], Latin America [36], and the U.S. [37]. In China, one of the five key objectives of China’s new healthcare reform, launched in 2009, is to strengthen the basic-level health service delivery system, especially the rural health system.…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction with Rural Medical Services: A Cross-Sectional Survey in 11 Western Provinces in China

Liu

Mao

2019

IJERPH

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Rural medical services play an important role in protecting and promoting the health of the rural population; however, patient satisfaction with rural medical services has been understudied in China. A better understanding of the actual situation and the determinants involved will provide evidence for health-related policy makers and hospital managers to further improve rural medical services. A total of 9811 patients (5208 outpatients and 4603 inpatients) were included in this study from a cross-sectional survey conducted in rural hospitals from 11 western provinces in China. Three in five patients (including outpatients and inpatients) were satisfied with rural medical services. The mean overall satisfaction scores were 3.61 ± 0.857 and 3.80 ± 0.829 (out of a maximum of 5) for rural outpatients and inpatients, respectively. The most satisfying domains for outpatients and inpatients were medical service attitude and illness explanation, and waiting time and medical expenses were the domains that outpatients and inpatients were least satisfied with. Satisfaction with medical technology (OR: 1.73; 95% CI: 1.57–1.92) and satisfaction with trust in physicians (OR: 2.05; 95% CI: 1.85–2.28) were identified as the strongest predictors of outpatients’ and inpatients’ overall satisfaction with rural medical services, respectively. This study might shed light on rural medical services management in China.

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Advancing the health of women and newborns: predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda

Cited by 15 publications

References 25 publications

Mothers’ satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique

Mothers’ satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique

The All Babies Count Initiative: Impact of a Health System Improvement Approach on Neonatal Care and Outcomes in Rwanda

Patient Satisfaction with Rural Medical Services: A Cross-Sectional Survey in 11 Western Provinces in China

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