Factors determining satisfaction among facility-based maternity clients in Nepal
Factors determining satisfaction among facility-based maternity clients in Nepal
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DOI：
10.1186/s12884-017-1532-0
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发表时间：
2017-09-25
影响因子：
3.1
通讯作者：
Barnett, Sarah
中科院分区：
文献类型：
--
作者：
Mehata, Suresh;Paudel, Yuba Raj;Barnett, Sarah
背景资料：随着住院分娩数量的增加，尼泊尔卫生系统面临着确保服务质量的挑战。本文的目的是确定客户满意度的决定因素与产妇护理在尼泊尔使用的数据，从全国代表性的卫生设施调查。方法：在尼泊尔13个县共进行了447次离职面谈，对象是最近分娩或有产科并发症的妇女（87%在医院，8%在初级保健中心，5%在次级保健站）。客户满意度的测量使用8个项目的规模，包括无障碍，人际沟通，物理环境，技术方面的照顾和决策。客户满意度指数采用有序主成分分析计算。一个多变量概率模型被用来评估客户satisfaction.Results的解释变量的净效应：较长的等待时间和过度拥挤增加了不满的可能性。有机会提问与客户满意度呈正相关。来自山区和农村地区的受访者比来自山区、德赖平原和城市地区的受访者更有可能感到满意。社会人口因素（年龄、均等、种姓/种族、教育和生态区）和供方因素（到达设施所需的时间，设施类型，服务费用，未知的卫生工作者或任何进入产房的人）与满意度没有统计学相关性。结论：调查结果表明，通过减少等待时间和过度拥挤，给母亲们足够的时间提问。如果客户更满意，他们更有可能再次使用该设施/推荐给朋友。
Background: With an increasing number of institutional deliveries, the Nepalese health system faces a challenge to ensure a quality of service provision. This paper aims to identify the determinants of client satisfaction with maternity care in Nepal using data from a nationally representative health facility survey.Methods: A total of 447 exit interviews, with women who had either recently delivered or who had experienced obstetric complications, were conducted across 13 districts in Nepal (87% in hospitals, 8% in Primary Health Care Centres (PHCCs), and 5% in Sub/Health Posts(S/HPs). Client satisfaction was measured using an eight item scale that covered accessibility, interpersonal communication, physical environment, technical aspect of care and decision making. A client satisfaction index was computed using ordinal principal component analysis. A multivariate probit model was used to assess the net effect of explanatory variables on client satisfaction.Results: Longer waiting times and overcrowding increased the likelihood of dissatisfaction. Having an opportunity to ask questions was positively associated with client satisfaction. Respondents from hill districts and rural areas were more likely to be satisfied in comparison to respondents from mountain, terai and urban areas. Sociodemographic factors (age, parity, caste/ethnicity, education, and ecological zone) and supply side factors (the time taken to reach a facility, type of facility, payment for services, and unknown heath worker or anyone entering the delivery room) were not statistically associated with satisfaction.Conclusions: The findings suggest client satisfaction with the quality of maternity services in Nepal could be improved by reducing waiting times and overcrowding, and giving the mothers adequate time to ask questions. If clients are more satisfied they are more likely to use the facility again/recommend to a friend.