An assessment of patient satisfaction among women receiving Antenatal Care(ANC) services in Harare city clinics.

Abstract

Patient satisfaction is a reflection of patient’s judgment of different domains of the health care system, which includes the interpersonal, organizational and the technical aspects. An understanding of the patient’s experience with respect to health care delivery system is very important in obtaining valid information about the quality of care provided and to identify problem areas which need to be improved. This study aimed to assess factors associated with patient satisfaction among women receiving Antenatal Care (ANC)services at Harare city clinics. Materials and Methods An analytic cross-sectional study was conducted at nine Harare city clinics that offer ANC services. Three hundred and sixty-one pregnant women were interviewed using a self-administered questionnaire. Three focus group discussions (FGDs) were also conducted to collect qualitative data. Quantitative data were analyzed using Epi info 7to generate frequencies and compute prevalence odds ratios (POR), 95% Cl and p-values. Thematic analysis was done to analyze data from FGDs. The overall patient satisfaction rate in this study was 47%. Older women(POR 0.49; 95% Cl 0.24-0.96)and those who were unemployed(POR 2.5; 95% Cl 1.63-3.18) were more likely to be satisfied with the ANC services and this was statistically significant. Health provider-related factors that were positively associated with patient satisfaction were preference for female health care providers (POR 12.4; 95% Cl 1.34-4.45), perceived adequate consultation time (POR 4.53; 95% Cl 2.86-7.16)and perceived privacy during physical examination (POR 5.09; 95% Cl 3.22-8.03). Health systems factors that were positively associated with patient satisfaction were good quality of the basic amenities (POR 2.42; 95% Cl 1.55-3.80), adequate waiting time (POR 5.07; 95% Cl 3.22-7.97) and subsidizeduser fees (POR 2.37;95% Cl 1.75-4.25).Results from the thematic analysis indicated that pregnant women, especially those who utilized clinics in high density surburbs were not satisfied with maternity services. The overall level of patient satisfaction in this study was generally low compared with other previous studies. Subsidizing user fees, reducing waiting time, improving the quality of basic amenities and the interpersonal relationship between the health care providers and patients might improve the level of patient satisfaction in Harare city clinics.