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Background. Ensuring patient satisfaction is an important means of secondary prevention of maternal mortality. This study presents findings from a multidimensional study of client satisfaction from the Gamo Gofa Zone in Southwest Ethiopia. Methods. A facility based cross-sectional study using exit interviews was conducted from 2014. Client satisfaction was measured using a survey adopted from the Donabedian quality assessment framework. Thirteen health institutions were randomly sampled of 66 institutions in Gamo Gofa Zone. Logistic regression was used to determine predictors of client satisfaction. Results. The overall satisfaction level of the clients in this study was 79.1% with (95% CI; 75-82). Women attending health centres were more likely satisfied than women attending hospitals (χ 2 = 83.7, d f = 12, P < 0.001). The proportion of women who complained about an unfriendly attitude or unresentful care from health workers was higher in the hospitals (χ 2 = 27.4, d f = 1, P < 0.001). The presence of support persons during child birth improved client satisfaction (AOR = 6.23 95% CI; 2.75-14.1) and women who delivered with caesarean section are four times more likely satisfied than those who deliver vaginally (AOR 3.6 95% CI; 1.44-9.06). Client satisfaction was reduced if the women had to pay for the services (AOR = 0.27 95% CI; 0.09-81). Conclusions. The study shows that overall satisfaction level is good. More emphasis should be put on giving women friendly care, particularly at the hospitals.
A facility based cross-sectional study was conducted from December 17, 2013, to January 27, 2014, in thirteen public health facilities of Gamo Gofa Zone. The capital town of the zone, Arba Minch, is located about 500 km southwest of Addis Ababa. In 2013 the population of the zone was 1.847.264 people; of them 440, 449 were women in reproductive age. The zone has two town administrations and 15 woredas (districts) with three hospitals and 63 health centers which provide delivery services. Using the results from previous studies with client satisfaction of 83%, the sample size was calculated using Epi Info Version 7 with the following assumptions: 80% power, 95% confidence level, odd ratio 2, design effect of 1.5, and 5% nonresponse rate. The estimated sample size was thus 435 women. We randomly selected 13 health institutions for the study from a sampling frame of 66 health institutions in Gamo Gofa Zone. The total number of delivering mothers in each health institution was calculated based on proportional to the number of deliveries attended at the health institutions in the last three months. Finally data was collected from every other woman who delivered in those health facilities till the required sample size was reached. Data was collected using a survey instrument adopted from the Donabedian quality assessment framework [12]. Thirteen unemployed midwives were initially trained and later collected the data, and 3 persons with B.S. degrees in public health supervised the data collection. The interviews were done when the patient was discharged from the institution. It was conducted in Amharic language after the questions were pretested and necessary modifications were made. The Statistical Package for Social Sciences version 16.0 (SPSS Inc., Chicago, IL, USA) was used for data management and analysis. We used descriptive statistics and binary logistic regression for this work. It is the satisfaction of mothers gained during service delivery. It is the care level gained that increases the likelihood of future utilization maternal health service. A five-point Likert scale ((1) very unsatisfied, (2) unsatisfied, (3) neutral, (4) satisfied, and (5) very satisfied) was used. For the overall satisfaction level, those who will be satisfied in greater than or equal to 75% of the items were categorized as satisfied and those who were satisfied in less than 75% of the items were categorized as unsatisfied [11]. Approach focuses on the rights of women to have access to quality care for themselves as individuals and as mothers and for their infantsand all health providers consider respectful care and support women's emotional, psychological, and social well-being during child birth [13]. Before the study was conducted, ethical clearance was obtained from Institutional Research Ethical Review Committee of Arba Minch University. After getting ethical clearance, written permission was obtained from Zonal Health Department and from the woreda health offices. Informed verbal consent from each study participant was obtained after explaining the purpose of the study. Individuals were given the right to participate on voluntary basis and if they did not volunteer to continue from the beginning or at any stage of the interview, they were given the right to withdraw from the study without any consequences. Privacy and strict confidentiality were maintained during the interview process. The information that was collected from this research was kept confidential and stored in files, which did not have participant name on it, but a code number assigned to it, and it was not revealed to anyone except the principal investigator.
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