Using mixed methods to evaluate perceived quality of care in southern Tanzania

Abstract

ObjectiveTo compare perceived quality of maternal and newborn care using quantitative and qualitative methods.DesignA continuous household survey (April 2011 to November 2013) and in-depth interviews and birth narratives.SettingTandahimba district, Tanzania.ParticipantsWomen aged 13–49 years who had a birth in the previous 2 years were interviewed in a household survey. Recently delivered mothers and their partners participated in in-depth interviews and birth narratives.InterventionNone.Main Outcome MeasuresPerceived quality of care.ResultsQuantitative: 1138 women were surveyed and 93% were confident in staff availability and 61% felt that required drugs and equipment would be available. Drinking water was easily accessed by only 60% of respondents using hospitals. Measures of interaction with staff were very positive, but only 51% reported being given time to ask questions. Unexpected out-of-pocket payments were higher in hospitals (49%) and health centres (53%) than in dispensaries (31%). Qualitative data echoed the lack of confidence in facility readiness, out-of-pocket payments and difficulty accessing water, but was divergent in responses about interactions with health staff. More than half described staff interactions that were disrespectful, not polite, or not helpful.ConclusionBoth methods produced broadly aligned results on perceived readiness, but divergent results on perceptions about client–staff interactions. Benefits and limitations to both quantitative and qualitative approaches were observed. Using mixed methodologies may prove particularly valuable in capturing the user experience of maternal and newborn health services, where they appear to be little used together.

Understanding client and provider perspectives of antenatal care service quality: a qualitative multi-method study from Tanzania

“…These findings complement others from the literature on quality of care in this setting. Results from other studies in Tanzania similarly indicate that client' s perception of the quality of maternal care received is influenced by having a respectful, knowledgeable provider, availability of medicines, availability of medical equipment, and timely provision of services [27][28][29][30][31][32], and that the greatest predictor of health facility preference was kind treatment by the provider [33]. While past research establishes experience of care as an important component of a quality health service, the existing literature does not always clearly define what aspects are most important to clients and providers nor identify areas of overlapping importance between clients and providers.…”

Socio-demographic determinants of women’s satisfaction with prenatal and delivery care services in Italy

“…The factors that have been shown to matter are, for instance, respect for the patient and her dignity, emotional support by the staff, contact with friends and family, information and guidelines, physical comfort, trust in treatment providers, autonomy and participation in decision-making; and confidentiality [ 28 – 34 ]. Of course, expectations play a major role in this sphere: when services meet women’s expectations of care, women are usually satisfied and tend to report a higher quality of care [ 31 ]. Education is one of the most important intervening variables here [ 35 , 36 ]: it shapes expectations, and thus influences satisfaction: women with low education frequently report feeling alone, ignored or harassed [ 31 ].…”

Moterų gimdymo ir pogimdyminės priežiūros lūkesčių vertinimas moterų nuomone

“…Tuo tarpu moterų gimdymo patirčių baigtis ir įvertinimas didžiausia dalimi priklauso nuo sveikatos priežiūros specialisto [1,5,11,12,18], kuris priima gimdymą ir suteikia (arba nesuteikia) moteriai reikalingą informaciją gimdymo metu [9,10,23], bendravimo ir bendradarbiavimo aspektų [6,14,16,21] nepriklausomai nuo kultūrinių [15,19], socialinių [7], tautinių [20] ar ekonominių [20,21] skirtumų.…”