“Lived experiences of young women of the quality of obstetric care services provided by midwives at Mabvuku Birthing Centre and its satellites in Harare, Zimbabwe”

Abstract

The quality of obstetric care services (QOCS) tends to determine young women’s choice of where to receive the intended services, yet in lower income countries like Zimbabwe little research on such services is documented. The purpose of this study was to explore the lived experiences of child-bearing age women of the QOCS regarding the QOCS provision in maternity clinics in Harare eastern district and its Satellites in order to understand the degree of their satisfaction with the obstetric care (OC) that they received. Also, to develop a model of care that can fulfil the knowledge and theory gap. Permission was approved by the relevant Research Ethics Committees for protection of the participants. A descriptive phenomenological qualitative approach was used to hear from the perspective of the care users. Data were collected until saturation. Giorgi’s technique analysed the data and a Hulton, et. al., (2000/2007) and the Southern Relational Path frameworks were used to guide the study. Semi–structured interview guides were used for the focus group discussions and individual in–depth interview platforms, and notes were written in a research diary and transcriptions were done daily after recording. Thirty-one participants were purposefully recruited from the pre-natal, labour, post-natal records and those who came for post-natal care services after consenting.Some women were satisfied with the QOCS that they received, citing warm and sensitive reception especially from the male midwives, while others were dissatisfied with the care. They mentioned poor monitoring of deliveries that led to self-deliveries, lack of empathy, rudeness and mistreatment during labour and birthing. Some environmental barriers such as crowdedness in the admissions room, labour, and post-natal rooms were reported. Confusing, inadequate and inconsistent information on family planning drugs, immunizations and breastfeeding concepts were reported. Insensitive cultural and religious values among the care providers were also noted as cause for concern. A model of care that might provide some useful insights that could improve the care and eventually improve QOCS was developed. The study concludes that women prefer quality obstetric care that constitutes the availability of resources both physical and human, namely trained and competent staff; medicines and sundries; longer clinic stays in order to rest and gain more information on infant care and breastfeeding and adequate space to allow husbands and significant others to accompany them on booking day. Staff need to be warm and empathetic, culturally and religiously sensitive for better maternity care uptake.