Antenatal Care Services Satisfaction and Associated Factors among Pregnant Women Attending Antenatal Care at Public Health Facilities in Harari Region, Eastern Ethiopia

Abstract

Introduction: Antenatal care can help women prepare for delivery and understand warning signs during pregnancy and childbirth. World Health Organization recommends a minimum of four antenatal visits. In our country Ethiopia proportion of pregnant women who received the recommended minimum of four or more antenatal care visit was (32%). Client satisfaction is playing an important role in quality of antenatal care. Evaluating to what extent patients are satisfied with health services is clinically relevant, as satisfied patients are more likely to comply with treatment, take an active role in their own care, to continue using medical care services and recommend center‘s services to others. However, there is limited evidence regarding ANC services satisfaction among pregnant women in our country Ethiopia including the study setting. Objective: The aim of this study was to assess ANC services satisfaction and associated factors among pregnant women attending Antenatal care at Public Health facilities in Harari Region, Eastern Ethiopia. Materials and Methods: This study was conducted from February 01 to February 30/2017. Institution based cross-sectional study design supplemented by qualitative inquiry with phenomenological study design was used among randomly selected 531 pregnant women. For quantitative part of the study sample size was calculated and proportionally allocated to each health facility included in the study and for the qualitative part of the study four FGDs were conducted with 6-10 pregnant women in each FGD by using convenience sampling technique to select the pregnant women for FGD. Quantitative data were collected using interviewer administered pretested structured questionnaire. Odds ratio along with 95% confidence interval were estimated to measure the strength of association and identify factors associated with an outcome variable of interest. Level of statistical significance was declared at p- value less than 0.05. Qualitative data were gathered through focus group discussion and analyzed using Narrative analysis method to support the quantitative result. x Result: The findings of this study revealed that the proportion of women satisfied with ANC service was 70.3% (95% CI: 66.4%, 74.3%). Greater proportion of satisfaction was recorded on interpersonal skill 78.3% but 39% of the respondents were unsatisfied with technical aspect of antenatal care. Pregnant women who utilize service in Hospital were 2.44 times [AOR = 2.44, 95% CI: 1.50, 3.98] more likely to be satisfied with ANC services than those who received in health center , those who had no formal education were 2.53 times [ AOR = 2.53 95% CI: 1.52, 4.20] and those who attended Primary education 2.17 times [(AOR = 2.17, 95% CI: 1.17, 4.04] more likely to be satisfied with ANC services than who had secondary and above education, those who had a repeated ANC visit were 4.62 times [AOR = 4.62, 95% CI: 2.98, 7.17] more likely to be satisfied with ANC services than who had first visit/new, those who begun ANC within the first trimester were 1.74 times [AOR = 1.74, 95% CI: 1.12, 2.71] more likely to be satisfied with ANC services than who begun ANC after first trimester, those who had no history of stillbirth were 2.52 times [AOR = 2.52, 95% CI: 1.37, 4.65] more likely to be satisfied with ANC services than who had history of stillbirth, and those who waited for no more than half an hour were 2.31 times [AOR = 2.31 95% CI: 1.28, 4.16] more likely to be satisfied with ANC services than who waited for more than 30 minute in the health facility to get service. Conclusion: About 70 % of pregnant women were satisfied with the antenatal care they received. Moreover, type of health facility, educational status of pregnant women, frequency of ANC, initiation time of ANC, waiting time to get service and history of stillbirth were identified as significant factors of ANC service satisfaction. Therefore, the hospital administration and health professionals need to offer client oriented service to increase their satisfaction.