Women's overall satisfaction with health facility delivery services in Ghana: a mixed-methods study
Women's overall satisfaction with health facility delivery services in Ghana: a mixed-methods study
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DOI：
10.1186/s41182-019-0172-7
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发表时间：
2019-07-05
影响因子：
4.5
通讯作者：
Agyekum, Enoch Oti
中科院分区：
文献类型：
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作者：
Adjei, Kwame K.;Kikuchi, Kimiyo;Agyekum, Enoch Oti
在加纳，熟练分娩率已上升至近74%，但其质量多年来一直受到质疑。了解妇女的满意度可能是重要的，以提高服务质量，本研究旨在确定哪些因素与妇女的整体满意度交付服务的定量和定性在农村Ghanaian卫生facility.ResultsThis横断面，混合方法研究使用了一个解释性的顺序设计在2013年加纳卫生服务研究领域。参与者是在过去20年内分娩的妇女。采用两阶段随机抽样方法招募妇女参加定量调查。妇女的社会人口特征和他们的整体满意度与卫生设施提供服务之间的关系进行了研究，采用单变量和多元Logistic回归分析。对于定性分析，有目的地选择完成定量调查的妇女参加焦点小组讨论。焦点小组讨论的数据进行了分析的基础上预定义的和新出现的主题。总体而言，1 130名妇女被纳入定量分析，136名妇女参加了15次重点小组讨论。女性的平均年龄为29岁。几乎所有妇女（94%）都对分娩期间得到的总体服务感到满意。与未受教育的妇女相比，具有中等/初中教育程度的妇女[调整的比值比（AOR）=0.50，95%置信区间（CI）=（0.26-0.98）]对总体分娩服务的满意度较低。Qualificance，妇女不满意的非常规的需求，消极的态度，和不可用的医护人员，以及漫长的等待时间。ConclusionsAlthough大多数妇女都满意的整体服务，他们在分娩过程中收到的，他们不满意的具体方面的卫生服务，因此，更高质量的服务提供是必要的，以提高妇女的满意度。额外的敏感性培训和减少工作时间也可以改善客户的体验。
BackgroundSkilled birth delivery has increased up to nearly 74% in Ghana, but its quality has been questioned over the years. As understanding women's satisfaction could be important to improving service quality, this study aimed to determine what factors were associated with women's overall satisfaction with delivery services quantitatively and qualitatively in rural Ghanaian health facilities.ResultsThis cross-sectional, mixed methods study used an explanatory sequential design across three Ghana Health Service research areas in 2013. Participants were women who had delivered in the preceding 2years. Two-stage random sampling was used to recruit women for the quantitative survey. Relationships between women's socio-demographic characteristics and their overall satisfaction with health facility delivery services were examined using univariate and multiple logistic regression analyses. For qualitative analyses, women who completed the quantitative survey were purposively selected to participate in focus group discussions. Data from the focus group discussions were analyzed based on predefined and emerging themes. Overall, 1130 women were included in the quantitative analyses and 136 women participated in 15 focus group discussions. Women's mean age was 29years. Nearly all women (94%) were satisfied with the overall services received during delivery. Women with middle level/junior high school education [adjusted odds ratio (AOR)=0.50, 95% confidence interval (CI)=(0.26-0.98)] were less likely to be satisfied with overall delivery services compared to women with no education. Qualitatively, women were not satisfied with the unconventional demands, negative attitude, and unavailability of healthcare workers, as well as the long wait time.ConclusionsAlthough most women were satisfied with the overall service they received during delivery, they were not satisfied with specific aspects of the health services; therefore, higher quality service delivery is necessary to improve women's satisfaction. Additional sensitivity training and a reduction in work hours may also improve the experience of clients.