Perceived Quality of Delivery Services among Mothers Who Gave Birth in Public Health Facilities in Three Districts of Jimma Zone, Southwest Ethiopia

Abstract

Background: Quality of institutional delivery service is an important intervention towards increasing clients’ utilization of skilled attendance at birth and accelerating improvements in newborn’s and maternal survival and well-being. Quality of the provision of care in facilities is fundamental to ensuring effective care; women’s actual experience of care is a significant, but often neglected aspect of quality of care that contributes to maternity outcomes. Objective: To assess perceived quality of institutional delivery services and identify associated factors in the three dimensions among women who delivered in public health facilities in three districts of Jimma zone, southwest Ethiopia, 2016. Method: The study was conducted in three districts of Jimma zone, Oromia Regional State, Southwestern Ethiopia. From February 29-March 20/2016 through community based cross sectional study design. The study participants were mothers who delivered in public health institution in the last 12 months. A simple random sampling technique was used to select 423 study participants. Principal component analysis was used to generate scores for the dimensions. Descriptive statistics, bi-variate and multivariate linear regression analysis were performed. P-value less than 0.05 and 95% confidence intervals were used to determine an association between independent and dependent variables. Result: Four hundred eleven respondents were interviewed using structured questionnaire, yielding a response rate of 97.2%. Perceived quality of institutional delivery services percentage mean score from the three dimensions were; interpersonal interaction 63%, health care delivery 70% and health facility/structure 58%. Educational level (read and write) (β: -0.331, 95% CI: -0.523,-0.140), urban residence (β: -0.485, 95% CI: -0.696,-0.275), Antenatal care(less than three visits) (β: -0.238, 95% CI: - 0.419,-0.056) and mothers attended delivery services by male (β: -1.286, 95% CI: -1.463,-1.109) were statistically associated with lower level of perceived quality of interpersonal interaction score. Whereas second wealth quintile (β: 0.278, 95% CI: 0.04-0.516) was statistically associated with higher perceived quality of interpersonal interaction score. Still birth (β: -0.642, 95% CI: -1.092,-0.193) and mothers attended delivery services by male (β: -0.689, 95% CI: -0.907,-0.472) were statistically associated with lower perceived quality of health care delivery score. Urban residence (β: -0.260, 95% CI: -0.515,-0.005), and Antenatal care(less than three visits) (β: -0.394, 95% CI: -0.628,-0.161) were statistically associated with lower perceived quality of health facility/structure score. Conclusion: Overall, the perceived quality of institutional delivery services in public health institutions in three districts of Jimma zone were rated low both in the interpersonal interaction and health facility/structure dimension and good in health care delivery dimension. Improvements should be emphasized on client centered service provision through responsiveness to client preference for female provider and increase uptake of Antenatal care services