Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study

Abstract

Background: Substantial improvements have been observed in the coverage and access to maternal health services in Ethiopia. However, quality of care has been lagging behind. Therefore, the aim of this study was to assess quality of Option B+ PMTCT service provision. Methods: Facility based cross sectional study was conducted from February to April 2016 in Northern Ethiopia. The quality of service delivery was assessed in 12 health facilities based on Donabedian input-process-output quality components. It employed mixed method approach involving both quantitative and qualitative data. Facilities were categorized rendering good input service quality if scored 100 % as per national guideline; whilst, 90 % and more for process and output quality components respectively. The emerged themes of factors for good and bad service quality from content analysis were then thematically fitted to donabedian themes. Results: Overall 2 of 12 (16.7%) facilities fulfilled all the three quality components according to predetermined judgment criteria. The input quality was better than their counterpart; in which it was judged as good in 33.3% of facilities. Besides, one fourth of them were realized process and output quality. We identified multiple barriers and facilitators for good and bad service quality in respective quality components influencing quality of care. Conclusion: Only 16.7% of facilities declared the overall quality in all three dimensions according to service delivery guideline. The desired level of quality will be realized if and only if the three quality components would be kept on eye side by side in line with identified facilitators and barriers for good and bad service quality.