Adjei Kwame K, Kikuchi Kimiyo, Owusu-Agyei Seth, Enuameh Yeetey, Shibanuma Akira, Ansah Evelyn Korkor, Yasuoka Junko, Poku-Asante Kwaku, Okawa Sumiyo, Gyapong Margaret, Tawiah Charlotte, Oduro Abraham Rexford, Sakeah Evelyn, Sarpong Doris, Nanishi Keiko, Asare Gloria Quansah, Hodgson Abraham, Jimba Masamine
1Kintampo Health Research Centre, Kintampo, Brong-Ahafo Ghana.
2Institute of Decision Science for a Sustainable Society, Kyushu University, Fukuoka, Japan.
Trop Med Health. 2019 Jul 5;47:41. doi: 10.1186/s41182-019-0172-7. eCollection 2019.
Skilled birth delivery has increased up to nearly 74% in Ghana, but its quality has been questioned over the years. As understanding women's satisfaction could be important to improving service quality, this study aimed to determine what factors were associated with women's overall satisfaction with delivery services quantitatively and qualitatively in rural Ghanaian health facilities.
This cross-sectional, mixed methods study used an explanatory sequential design across three Ghana Health Service research areas in 2013. Participants were women who had delivered in the preceding 2 years. Two-stage random sampling was used to recruit women for the quantitative survey. Relationships between women's socio-demographic characteristics and their overall satisfaction with health facility delivery services were examined using univariate and multiple logistic regression analyses. For qualitative analyses, women who completed the quantitative survey were purposively selected to participate in focus group discussions. Data from the focus group discussions were analyzed based on predefined and emerging themes. Overall, 1130 women were included in the quantitative analyses and 136 women participated in 15 focus group discussions. Women's mean age was 29 years. Nearly all women (94%) were satisfied with the overall services received during delivery. Women with middle level/junior high school education [adjusted odds ratio (AOR) = 0.50, 95% confidence interval (CI) = (0.26-0.98)] were less likely to be satisfied with overall delivery services compared to women with no education. Qualitatively, women were not satisfied with the unconventional demands, negative attitude, and unavailability of healthcare workers, as well as the long wait time.
Although most women were satisfied with the overall service they received during delivery, they were not satisfied with specific aspects of the health services; therefore, higher quality service delivery is necessary to improve women's satisfaction. Additional sensitivity training and a reduction in work hours may also improve the experience of clients.
在加纳，熟练接生率已提高到近74%，但多年来其质量一直受到质疑。由于了解妇女的满意度对于提高服务质量可能很重要，本研究旨在从定量和定性两方面确定加纳农村卫生设施中与妇女对分娩服务的总体满意度相关的因素。
这项横断面混合方法研究于2013年在加纳卫生服务局的三个研究区域采用了解释性序列设计。参与者为前两年内分娩的妇女。采用两阶段随机抽样法招募妇女进行定量调查。使用单变量和多变量逻辑回归分析来检验妇女的社会人口特征与其对卫生设施分娩服务的总体满意度之间的关系。对于定性分析，有目的地选择完成定量调查的妇女参加焦点小组讨论。根据预先确定的主题和新出现的主题对焦点小组讨论的数据进行分析。总体而言，1130名妇女纳入了定量分析，136名妇女参加了15次焦点小组讨论。妇女的平均年龄为29岁。几乎所有妇女（94%）对分娩期间获得的总体服务感到满意。与未受过教育的妇女相比，接受过初中教育的妇女对总体分娩服务感到满意的可能性较小[调整后的优势比（AOR）=0.50，95%置信区间（CI）=（0.26 - 0.98）]。定性分析表明，妇女对医护人员提出的不合理要求、消极态度、无法提供服务以及长时间等待感到不满。
尽管大多数妇女对她们在分娩期间获得的总体服务感到满意，但她们对卫生服务中的某些具体方面并不满意；因此，有必要提供更高质量的服务以提高妇女的满意度。额外的敏感性培训和减少工作时间也可能改善服务对象的体验。
