尼日利亚转诊医院中妇女对孕产妇保健满意度的定性评估。
Qualitative assessment of women's satisfaction with maternal health care in referral hospitals in Nigeria.
作者信息
Okonofua Friday, Ogu Rosemary, Agholor Kingsley, Okike Ola, Abdus-Salam Rukiyat, Gana Mohammed, Randawa Abdullahi, Abe Eghe, Durodola Adetoye, Galadanci Hadiza
机构信息
Women's Health and Action Research Centre WHARC, Benin, Edo State, Nigeria.
University of Medical Sciences, Ondo, Ondo State, Nigeria.
出版信息
Reprod Health. 2017 Mar 16;14(1):44. doi: 10.1186/s12978-017-0305-6.
BACKGROUND
Available evidence suggests that the low use of antenatal, delivery, and post-natal services by Nigerian women may be due to their perceptions of low quality of care in health facilities. This study investigated the perceptions of women regarding their satisfaction with the maternity services offered in secondary and tertiary hospitals in Nigeria.
METHODS
Five focus group discussions (FGDs) were held with women in eight secondary and tertiary hospitals in four of the six geo-political zones of the country. In all, 40 FGDs were held with women attending antenatal and post-natal clinics in the hospitals. The questions assessed women's level of satisfaction with the care they received in the hospitals, their views on what needed to be done to improve patients' satisfaction, and the overall quality of maternity services in the hospitals. The discussions were audio-taped, transcribed, and analyzed by themes using Atlas ti computer software.
RESULTS
Few of the participants expressed satisfaction with the quality of care they received during antenatal, intrapartum, and postnatal care. Many had areas of dissatisfaction, or were not satisfied at all with the quality of care. Reasons for dissatisfaction included poor staff attitude, long waiting time, poor attention to women in labour, high cost of services, and sub-standard facilities. These sources of dissatisfaction were given as the reasons why women often preferred traditional rather than modern facility based maternity care. The recommendations they made for improving maternity care were also consistent with their perceptions of the gaps and inadequacies. These included the improvement of hospital facilities, re-organization of services to eliminate delays, the training and re-training of health workers, and feedback/counseling and education of women.
CONCLUSION
A women-friendly approach to delivery of maternal health care based on adequate response to women's concerns and experiences of health care will be critical to curbing women's dissatisfaction with modern facility based health care, improving access to maternal health, and reducing maternal morbidity and mortality in Nigeria.
TRIAL REGISTRATION
Trial Registration Number NCTR No: 91540209. Nigeria Clinical Trials Registry. http://www.nctr.nhrec.net/ . Registered April 14th 2016.
背景
现有证据表明，尼日利亚女性对产前、分娩及产后服务利用率较低，可能是因为她们认为医疗机构的护理质量不高。本研究调查了女性对尼日利亚二级和三级医院提供的孕产妇服务满意度的看法。
方法
在该国六个地理政治区中的四个区的八家二级和三级医院与女性进行了五次焦点小组讨论（FGD）。总共与在医院产前和产后诊所就诊的女性进行了40次焦点小组讨论。问题评估了女性对在医院接受的护理的满意度水平、她们对如何提高患者满意度的看法以及医院孕产妇服务的整体质量。讨论进行了录音、转录，并使用阿特拉斯ti计算机软件按主题进行了分析。
结果
很少有参与者对她们在产前、产时和产后护理期间接受的护理质量表示满意。许多人有不满意的地方，或者对护理质量根本不满意。不满意的原因包括工作人员态度差、等待时间长、对分娩中的女性关注不足、服务成本高以及设施不达标准。这些不满的根源被认为是女性通常更喜欢传统而非现代设施的孕产妇护理的原因。她们提出的改善孕产妇护理的建议也与她们对差距和不足的看法一致。这些建议包括改善医院设施、重新组织服务以消除延误、对卫生工作者进行培训和再培训，以及对女性进行反馈/咨询和教育。
结论
基于对女性医疗保健关注和经历的充分回应，采取对女性友好的方式提供孕产妇保健，对于抑制女性对现代设施医疗保健的不满、改善孕产妇保健服务的可及性以及降低尼日利亚的孕产妇发病率和死亡率至关重要。
试验注册
试验注册号NCTR No: 91540209。尼日利亚临床试验注册中心。http://www.nctr.nhrec.net/ 。于2016年4月14日注册。
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