Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care.
Eshetu, T
Fekadu, E
Abdella, A
Mulushoa, A
Medhin, G
Belina, M
Alem, A
Keynejad, R
Robbins, T
Seward, N
Shennan, A
Howard, LM
Prince, M
Sandall, J
Hanlon, C
- Publisher:
- BMC
- Publication Type:
- Journal Article
- Citation:
- BMC Pregnancy Childbirth, 2025, 25, (1), pp. 85
- Issue Date:
- 2025-01-30
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Eshetu, T | |
dc.contributor.author | Fekadu, E | |
dc.contributor.author | Abdella, A | |
dc.contributor.author | Mulushoa, A | |
dc.contributor.author | Medhin, G | |
dc.contributor.author | Belina, M | |
dc.contributor.author | Alem, A | |
dc.contributor.author | Keynejad, R | |
dc.contributor.author | Robbins, T | |
dc.contributor.author | Seward, N | |
dc.contributor.author | Shennan, A | |
dc.contributor.author | Howard, LM | |
dc.contributor.author | Prince, M | |
dc.contributor.author |
Sandall, J |
|
dc.contributor.author | Hanlon, C | |
dc.date.accessioned | 2025-07-15T05:42:19Z | |
dc.date.available | 2024-12-25 | |
dc.date.available | 2025-07-15T05:42:19Z | |
dc.date.issued | 2025-01-30 | |
dc.identifier.citation | BMC Pregnancy Childbirth, 2025, 25, (1), pp. 85 | |
dc.identifier.issn | 1471-2393 | |
dc.identifier.issn | 1471-2393 | |
dc.identifier.uri | http://hdl.handle.net/10453/188267 | |
dc.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. | |
dc.format | Electronic | |
dc.language | eng | |
dc.publisher | BMC | |
dc.relation.ispartof | BMC Pregnancy Childbirth | |
dc.relation.isbasedon | 10.1186/s12884-024-07116-4 | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject | 1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services | |
dc.subject.classification | Obstetrics & Reproductive Medicine | |
dc.subject.classification | 3215 Reproductive medicine | |
dc.subject.classification | 4204 Midwifery | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Female | |
dc.subject.mesh | Ethiopia | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Patient-Centered Care | |
dc.subject.mesh | Cross-Sectional Studies | |
dc.subject.mesh | Patient Satisfaction | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Prenatal Care | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Infant, Newborn | |
dc.subject.mesh | Surveys and Questionnaires | |
dc.subject.mesh | Qualitative Research | |
dc.subject.mesh | Maternal Health Services | |
dc.subject.mesh | Rural Population | |
dc.subject.mesh | Intimate Partner Violence | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Prenatal Care | |
dc.subject.mesh | Cross-Sectional Studies | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Qualitative Research | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Infant, Newborn | |
dc.subject.mesh | Rural Population | |
dc.subject.mesh | Maternal Health Services | |
dc.subject.mesh | Patient Satisfaction | |
dc.subject.mesh | Patient-Centered Care | |
dc.subject.mesh | Ethiopia | |
dc.subject.mesh | Female | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Surveys and Questionnaires | |
dc.subject.mesh | Intimate Partner Violence | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Female | |
dc.subject.mesh | Ethiopia | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Cross-Sectional Studies | |
dc.subject.mesh | Patient Satisfaction | |
dc.subject.mesh | Patient-Centered Care | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Prenatal Care | |
dc.subject.mesh | Qualitative Research | |
dc.subject.mesh | Surveys and Questionnaires | |
dc.subject.mesh | Infant, Newborn | |
dc.subject.mesh | Rural Population | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Maternal Health Services | |
dc.title | Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care. | |
dc.type | Journal Article | |
utslib.citation.volume | 25 | |
utslib.location.activity | England | |
utslib.for | 1110 Nursing | |
utslib.for | 1114 Paediatrics and Reproductive Medicine | |
utslib.for | 1117 Public Health and Health Services | |
pubs.organisational-group | University of Technology Sydney | |
pubs.organisational-group | University of Technology Sydney/Faculty of Health | |
utslib.copyright.status | open_access | * |
dc.rights.license | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.date.updated | 2025-07-15T05:42:16Z | |
pubs.issue | 1 | |
pubs.publication-status | Published online | |
pubs.volume | 25 | |
utslib.citation.issue | 1 |
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.
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