Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care
Abstract Background Person-centred maternal care is associated with positive experiences in high-income countries. Little is known about the transferability of this concept to non-Western, low-income settings. We aimed to explore women’s experiences of care and investigate satisfaction with antenata...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-024-07116-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571273270525952 |
|---|---|
| author | Tigist Eshetu Eshcolewyine Fekadu Ahmed Abdella Adiyam Mulushoa Girmay Medhin Merga Belina Atalay Alem Roxanne Keynejad Tanya Robbins Nadine Seward Andrew Shennan Louise M. Howard Martin Prince Jane Sandall Charlotte Hanlon |
| author_facet | Tigist Eshetu Eshcolewyine Fekadu Ahmed Abdella Adiyam Mulushoa Girmay Medhin Merga Belina Atalay Alem Roxanne Keynejad Tanya Robbins Nadine Seward Andrew Shennan Louise M. Howard Martin Prince Jane Sandall Charlotte Hanlon |
| author_sort | Tigist Eshetu |
| collection | DOAJ |
| description | Abstract Background Person-centred maternal care is associated with positive experiences in high-income countries. Little is known about the transferability of this concept to non-Western, low-income settings. We aimed to explore women’s experiences of care and investigate satisfaction with antenatal care (ANC) in relation to person-centred care and unmet psychosocial needs in rural Ethiopia. Methods Design: facility-based, convergent mixed-method study. A cross-sectional survey included 2079 consecutive women attending ANC at eight health centres. Service satisfaction was measured using a 21-item validated measure. Independent variables: [1] person-centred care (1A: receipt of information; 1B: perceived adequacy of health worker responses) and [2] unmet psychosocial needs (2A: Patient Health Questionnaire for depressive symptoms; 2B: screening questionnaire for intimate partner violence (IPV)). Linear mixed effect regression assessed hypothesized associations between person-centred care/unmet psychosocial needs and service satisfaction, accounting for clustering at the health centre level. A linked qualitative study comprised eight in-depth interviews with women accessing ANC. Structured observations of ANC consultations rated health worker competencies (n = 65) and adherence to guidance promoting person-centred care (n = 53). Qualitative data were analysed thematically and triangulated with quantitative and observational data. Results Women reported lowest satisfaction in relation to family involvement (71.5% dissatisfied) and continuity of care (65.7% dissatisfied). As hypothesised, satisfaction increased with more information received (adjusted regression coefficient (ARC) 0.96 95%CI 0.71,1.20) but reported adequacy of help from health workers did not show a dose-response relationship (test-for-trend p = 0.157). Undetected depressive symptoms (ARC − 0.21 95%CI -0.27,-0.15) and IPV (ARC − 1.52; 95%CI -2.43,-0.61) were associated with lower service satisfaction scores. Most observed consultations scored low on most indicators of person-centred care. In qualitative interviews, women valued respectful and responsive communication from health workers, which affected their willingness to disclose psychosocial problems. Triangulation of findings indicated a mismatch between what women valued about care, their reported satisfaction with care and the actual care they were observed to receive. Conclusions Systems strengthening interventions to support person-centred maternal care appear contextually relevant but need to increase women’s expectations of care and agency to demand change. Prioritization of person-centred care could improve women’s experience of maternal care and better address psychosocial needs. |
| format | Article |
| id | doaj-art-e4c2faa720744bd4ba99cc518026eda3 |
| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-e4c2faa720744bd4ba99cc518026eda32025-02-02T12:46:39ZengBMCBMC Pregnancy and Childbirth1471-23932025-01-0125111310.1186/s12884-024-07116-4Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of careTigist Eshetu0Eshcolewyine Fekadu1Ahmed Abdella2Adiyam Mulushoa3Girmay Medhin4Merga Belina5Atalay Alem6Roxanne Keynejad7Tanya Robbins8Nadine Seward9Andrew Shennan10Louise M. Howard11Martin Prince12Jane Sandall13Charlotte Hanlon14Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa UniversityCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa UniversityDepartment of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Addis Ababa UniversityCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa UniversityCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa UniversityCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa UniversityDepartment of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Building, School of Medicine, College of Health Sciences, Addis Ababa UniversitySection of Women’s Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Women and Children’s Health, School of Life and Population Sciences, King’s College LondonCentre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College LondonDepartment of Women and Children’s Health, School of Life and Population Sciences, King’s College LondonSection of Women’s Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonKing’s Global Health Institute, King’s College LondonDepartment of Women and Children’s Health, School of Life and Population Sciences, King’s College LondonCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa UniversityAbstract Background Person-centred maternal care is associated with positive experiences in high-income countries. Little is known about the transferability of this concept to non-Western, low-income settings. We aimed to explore women’s experiences of care and investigate satisfaction with antenatal care (ANC) in relation to person-centred care and unmet psychosocial needs in rural Ethiopia. Methods Design: facility-based, convergent mixed-method study. A cross-sectional survey included 2079 consecutive women attending ANC at eight health centres. Service satisfaction was measured using a 21-item validated measure. Independent variables: [1] person-centred care (1A: receipt of information; 1B: perceived adequacy of health worker responses) and [2] unmet psychosocial needs (2A: Patient Health Questionnaire for depressive symptoms; 2B: screening questionnaire for intimate partner violence (IPV)). Linear mixed effect regression assessed hypothesized associations between person-centred care/unmet psychosocial needs and service satisfaction, accounting for clustering at the health centre level. A linked qualitative study comprised eight in-depth interviews with women accessing ANC. Structured observations of ANC consultations rated health worker competencies (n = 65) and adherence to guidance promoting person-centred care (n = 53). Qualitative data were analysed thematically and triangulated with quantitative and observational data. Results Women reported lowest satisfaction in relation to family involvement (71.5% dissatisfied) and continuity of care (65.7% dissatisfied). As hypothesised, satisfaction increased with more information received (adjusted regression coefficient (ARC) 0.96 95%CI 0.71,1.20) but reported adequacy of help from health workers did not show a dose-response relationship (test-for-trend p = 0.157). Undetected depressive symptoms (ARC − 0.21 95%CI -0.27,-0.15) and IPV (ARC − 1.52; 95%CI -2.43,-0.61) were associated with lower service satisfaction scores. Most observed consultations scored low on most indicators of person-centred care. In qualitative interviews, women valued respectful and responsive communication from health workers, which affected their willingness to disclose psychosocial problems. Triangulation of findings indicated a mismatch between what women valued about care, their reported satisfaction with care and the actual care they were observed to receive. Conclusions Systems strengthening interventions to support person-centred maternal care appear contextually relevant but need to increase women’s expectations of care and agency to demand change. Prioritization of person-centred care could improve women’s experience of maternal care and better address psychosocial needs.https://doi.org/10.1186/s12884-024-07116-4Antenatal carePatient satisfactionPerson-centred careQuality of careExperience of carePerinatal mental health |
| spellingShingle | Tigist Eshetu Eshcolewyine Fekadu Ahmed Abdella Adiyam Mulushoa Girmay Medhin Merga Belina Atalay Alem Roxanne Keynejad Tanya Robbins Nadine Seward Andrew Shennan Louise M. Howard Martin Prince Jane Sandall Charlotte Hanlon Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care BMC Pregnancy and Childbirth Antenatal care Patient satisfaction Person-centred care Quality of care Experience of care Perinatal mental health |
| title | Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care |
| title_full | Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care |
| title_fullStr | Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care |
| title_full_unstemmed | Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care |
| title_short | Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care |
| title_sort | towards person centred maternal and newborn care in ethiopia a mixed method study of satisfaction and experiences of care |
| topic | Antenatal care Patient satisfaction Person-centred care Quality of care Experience of care Perinatal mental health |
| url | https://doi.org/10.1186/s12884-024-07116-4 |
| work_keys_str_mv | AT tigisteshetu towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT eshcolewyinefekadu towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT ahmedabdella towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT adiyammulushoa towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT girmaymedhin towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT mergabelina towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT atalayalem towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT roxannekeynejad towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT tanyarobbins towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT nadineseward towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT andrewshennan towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT louisemhoward towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT martinprince towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT janesandall towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare AT charlottehanlon towardspersoncentredmaternalandnewborncareinethiopiaamixedmethodstudyofsatisfactionandexperiencesofcare |