Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda

C. Mutaganzwa; L. Wibecan; H. S. Iyer; E. Nahimana; A. Manzi; F. Biziyaremye; M. Nyishime; F. Nkikabahizi; Lisa Ruth Hirschhorn; H. Magge

doi:10.1093/intqhc/mzy103

Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda

C. Mutaganzwa^*, L. Wibecan, H. S. Iyer, E. Nahimana, A. Manzi, F. Biziyaremye, M. Nyishime, F. Nkikabahizi, Lisa Ruth Hirschhorn, H. Magge

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Objective: Identify predictors of patient satisfaction with antenatal care (ANC) and maternity services in rural Rwanda. Design: Cross-sectional. Setting: Twenty-six health facilities in Southern Kayonza (SK) and Kirehe districts. Participants: Sample of women ? 16 years old receiving antenatal and delivery care between November and December 2013. Intervention: Survey of patient satisfaction with antenatal and delivery care to inform quality improvement (QI) initiatives aimed at reducing neonatal mortality. Main Outcome Measure: Overall satisfaction with antenatal and delivery care (reported as excellent or very good). Results: In multivariate logistic regression analysis, high perceived quality [odds ratio (OR) = 3.03, 95% confidence intervals (CI): 1.565.88], respect [OR = 4.13, 95% CI: 2.16-7.89], and confidentiality [SK: OR = 7.50, 95% CI: 2.16-26.01], [Kirehe: OR = 1.54, 95% CI: 0.60-3.94] were associated with higher overall satisfaction with ANC, while having ?1 child compared to none [OR = 0.46, 95% CI: 0.25-0.84] was associated with lower satisfaction. For maternity services, <5 years of school versus ?5 years [OR = 0.13, 95% CI: 0.026-0.69] and higher cleanliness [OR = 19.23, 95% CI: 2.22-166.83], self-reported quality [OR = 10.52, 95% CI: 1.81-61.22], communication [OR = 8.78, 95%CI: 1.95-39.59], and confidentiality [OR = 8.66, 95% CI: 1.20-62.64] were all positively associated with high satisfaction. Higher comfort [OR: 0.050, 95% CI: 0.0034-0.71] and Kirehe vs. SK district [OR: 0.21, 95% CI: 0.042-1.01] were associated with lower satisfaction. Conclusions: Patient-centeredness (including interpersonal relationships), organizational factors, and location are important individual determinants of satisfaction for women seeking maternal care at study facilities. Understanding variation in these factors should inform QI efforts in maternal and newborn health programs.

Original language	English (US)
Pages (from-to)	793-801
Number of pages	9
Journal	International Journal for Quality in Health Care
Volume	30
Issue number	10
DOIs	https://doi.org/10.1093/intqhc/mzy103
State	Published - Dec 1 2018

Funding

This work was supported by the Doris Duke Charitable Foundation’s Africa Health Initiative. S.H.I. was supported in part by the National Institutes of Health research training grant [NIH, T32 CA 009001].

Keywords

Rwanda
antenatal care
delivery
maternal and newborn health
patient satisfaction
quality of healthcare

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Health Policy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/intqhc/mzy103

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Mutaganzwa, C., Wibecan, L., Iyer, H. S., Nahimana, E., Manzi, A., Biziyaremye, F., Nyishime, M., Nkikabahizi, F., Hirschhorn, L. R., & Magge, H. (2018). Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda. International Journal for Quality in Health Care, 30(10), 793-801. https://doi.org/10.1093/intqhc/mzy103

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title = "Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda",

abstract = "Objective: Identify predictors of patient satisfaction with antenatal care (ANC) and maternity services in rural Rwanda. Design: Cross-sectional. Setting: Twenty-six health facilities in Southern Kayonza (SK) and Kirehe districts. Participants: Sample of women ? 16 years old receiving antenatal and delivery care between November and December 2013. Intervention: Survey of patient satisfaction with antenatal and delivery care to inform quality improvement (QI) initiatives aimed at reducing neonatal mortality. Main Outcome Measure: Overall satisfaction with antenatal and delivery care (reported as excellent or very good). Results: In multivariate logistic regression analysis, high perceived quality [odds ratio (OR) = 3.03, 95% confidence intervals (CI): 1.565.88], respect [OR = 4.13, 95% CI: 2.16-7.89], and confidentiality [SK: OR = 7.50, 95% CI: 2.16-26.01], [Kirehe: OR = 1.54, 95% CI: 0.60-3.94] were associated with higher overall satisfaction with ANC, while having ?1 child compared to none [OR = 0.46, 95% CI: 0.25-0.84] was associated with lower satisfaction. For maternity services, <5 years of school versus ?5 years [OR = 0.13, 95% CI: 0.026-0.69] and higher cleanliness [OR = 19.23, 95% CI: 2.22-166.83], self-reported quality [OR = 10.52, 95% CI: 1.81-61.22], communication [OR = 8.78, 95%CI: 1.95-39.59], and confidentiality [OR = 8.66, 95% CI: 1.20-62.64] were all positively associated with high satisfaction. Higher comfort [OR: 0.050, 95% CI: 0.0034-0.71] and Kirehe vs. SK district [OR: 0.21, 95% CI: 0.042-1.01] were associated with lower satisfaction. Conclusions: Patient-centeredness (including interpersonal relationships), organizational factors, and location are important individual determinants of satisfaction for women seeking maternal care at study facilities. Understanding variation in these factors should inform QI efforts in maternal and newborn health programs.",

keywords = "Rwanda, antenatal care, delivery, maternal and newborn health, patient satisfaction, quality of healthcare",

author = "C. Mutaganzwa and L. Wibecan and Iyer, {H. S.} and E. Nahimana and A. Manzi and F. Biziyaremye and M. Nyishime and F. Nkikabahizi and Hirschhorn, {Lisa Ruth} and H. Magge",

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doi = "10.1093/intqhc/mzy103",

language = "English (US)",

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Mutaganzwa, C, Wibecan, L, Iyer, HS, Nahimana, E, Manzi, A, Biziyaremye, F, Nyishime, M, Nkikabahizi, F, Hirschhorn, LR & Magge, H 2018, 'Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda', International Journal for Quality in Health Care, vol. 30, no. 10, pp. 793-801. https://doi.org/10.1093/intqhc/mzy103

TY - JOUR

T1 - Advancing the health of women and newborns

T2 - Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda

AU - Mutaganzwa, C.

AU - Wibecan, L.

AU - Iyer, H. S.

AU - Nahimana, E.

AU - Manzi, A.

AU - Biziyaremye, F.

AU - Nyishime, M.

AU - Nkikabahizi, F.

AU - Hirschhorn, Lisa Ruth

AU - Magge, H.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objective: Identify predictors of patient satisfaction with antenatal care (ANC) and maternity services in rural Rwanda. Design: Cross-sectional. Setting: Twenty-six health facilities in Southern Kayonza (SK) and Kirehe districts. Participants: Sample of women ? 16 years old receiving antenatal and delivery care between November and December 2013. Intervention: Survey of patient satisfaction with antenatal and delivery care to inform quality improvement (QI) initiatives aimed at reducing neonatal mortality. Main Outcome Measure: Overall satisfaction with antenatal and delivery care (reported as excellent or very good). Results: In multivariate logistic regression analysis, high perceived quality [odds ratio (OR) = 3.03, 95% confidence intervals (CI): 1.565.88], respect [OR = 4.13, 95% CI: 2.16-7.89], and confidentiality [SK: OR = 7.50, 95% CI: 2.16-26.01], [Kirehe: OR = 1.54, 95% CI: 0.60-3.94] were associated with higher overall satisfaction with ANC, while having ?1 child compared to none [OR = 0.46, 95% CI: 0.25-0.84] was associated with lower satisfaction. For maternity services, <5 years of school versus ?5 years [OR = 0.13, 95% CI: 0.026-0.69] and higher cleanliness [OR = 19.23, 95% CI: 2.22-166.83], self-reported quality [OR = 10.52, 95% CI: 1.81-61.22], communication [OR = 8.78, 95%CI: 1.95-39.59], and confidentiality [OR = 8.66, 95% CI: 1.20-62.64] were all positively associated with high satisfaction. Higher comfort [OR: 0.050, 95% CI: 0.0034-0.71] and Kirehe vs. SK district [OR: 0.21, 95% CI: 0.042-1.01] were associated with lower satisfaction. Conclusions: Patient-centeredness (including interpersonal relationships), organizational factors, and location are important individual determinants of satisfaction for women seeking maternal care at study facilities. Understanding variation in these factors should inform QI efforts in maternal and newborn health programs.

AB - Objective: Identify predictors of patient satisfaction with antenatal care (ANC) and maternity services in rural Rwanda. Design: Cross-sectional. Setting: Twenty-six health facilities in Southern Kayonza (SK) and Kirehe districts. Participants: Sample of women ? 16 years old receiving antenatal and delivery care between November and December 2013. Intervention: Survey of patient satisfaction with antenatal and delivery care to inform quality improvement (QI) initiatives aimed at reducing neonatal mortality. Main Outcome Measure: Overall satisfaction with antenatal and delivery care (reported as excellent or very good). Results: In multivariate logistic regression analysis, high perceived quality [odds ratio (OR) = 3.03, 95% confidence intervals (CI): 1.565.88], respect [OR = 4.13, 95% CI: 2.16-7.89], and confidentiality [SK: OR = 7.50, 95% CI: 2.16-26.01], [Kirehe: OR = 1.54, 95% CI: 0.60-3.94] were associated with higher overall satisfaction with ANC, while having ?1 child compared to none [OR = 0.46, 95% CI: 0.25-0.84] was associated with lower satisfaction. For maternity services, <5 years of school versus ?5 years [OR = 0.13, 95% CI: 0.026-0.69] and higher cleanliness [OR = 19.23, 95% CI: 2.22-166.83], self-reported quality [OR = 10.52, 95% CI: 1.81-61.22], communication [OR = 8.78, 95%CI: 1.95-39.59], and confidentiality [OR = 8.66, 95% CI: 1.20-62.64] were all positively associated with high satisfaction. Higher comfort [OR: 0.050, 95% CI: 0.0034-0.71] and Kirehe vs. SK district [OR: 0.21, 95% CI: 0.042-1.01] were associated with lower satisfaction. Conclusions: Patient-centeredness (including interpersonal relationships), organizational factors, and location are important individual determinants of satisfaction for women seeking maternal care at study facilities. Understanding variation in these factors should inform QI efforts in maternal and newborn health programs.

KW - Rwanda

KW - antenatal care

KW - delivery

KW - maternal and newborn health

KW - patient satisfaction

KW - quality of healthcare

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Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda

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UN SDGs

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