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Introduction: Maternal satisfaction is a means of evaluating quality of maternal health care given in health facilities. The objective was to assess the level of maternal Satisfaction and associated factors at Asrade Zewude Memorial Primary Hospital. Method: Cross-sectional study was conducted on 420 clients by systematic sampling method from February 8, 2017 to September 25, 2017. Structured questionnaire that was prepared by Ethiopian Federal Ministry of Health was used. Pre-testing was done prior to the actual data collection process on a sample of 20 respondents and modified accordingly. The study was approved by Asrade Zewude Memorial Primary Hospital Senior Management Committee. The collected data were checked for completeness and consistency before being coded, entered and analyzed using SPSS version 16. Logistic regression was used to assess the presence of association between dependent and independent variables using SPSS at 95% CI and 5% margin of error. Result: The study revealed that level of satisfaction among delivering mothers was 88%. Educational level (AOR = 2.15, 95% CI = [1.02-3.71], access to ambulance service (AOR=3.15, 95% CI=[1.02-3.78], respect full delivery service (AOR=6.85, 95%CI=[4.35-6.95], welcoming hospital environment (AOR=3.09, 95% CI = [2.30-2.69], proper labor pain management (AOR=4.51, (95% CI=(3.12-5.01) and listening to their questions [AOR=3.95, 95%CI [2.35-4.36] were independent predictors for maternal satisfaction.Conclusion and Recommendation: Even though most of the participants were satisfied, they still had unmet needs and expectations in the delivery service provider. The identified main determinants were level of education, access to ambulance service, welcoming hospital environment, proper pain management and listening to their questions. Therefore, there is a need to improve the care given to maternity and appropriate strategy should be designed to address the unmet needs of mothers delivered in the hospital.

Background Work force is a crucial component of health services delivery system. Ethiopia faces health workforce challenges with regard to evidence based health work force planning. First the health worker to population ratio was used and later standard staffing schedule for each health facility level was used. Both of these methods did not address the issue of evidence based workload variation between the same levels of facilities at different locations within a country. A workload indicator of staffing need method (WISN) addresses these variations. Therefore this study was assumed for recommendation on use of WISN for health facilities based on WISN results of midwives at Asrade Zewude memorial Hospital. Methods Cross sectional study using WISN model was used to determine the gaps or excess and workload pressure in midwives at Asrade Zewude Memorial primary hospital, North West Ethiopia. Results The finding showed that there was five working days with 1030 hrs actual working time per year for midwives. This working time was spent on health service activities (58.4%), additional activities (36.6%) and support activities (5%). WISN calculation showed that a shortage of five midwives with WISN ratio of 0.8 at Asrade Zewude Memorial primary hospital North West Ethiopia. Conclusion Midwives at the study area were doing their routine work with 20% under staffed by covering the additional five midwives' position. With this working condition, it may be hard to achieve universal health coverage goals of the facility. Therefore the hospital should institutionalize WISN method to objectively employ midwifery professionals.

were independent predictors for maternal satisfaction. Even though most of the participants were satisfied, they still had unmet needs and expectations in the delivery service provider. The identified main determinants were level of education, access to ambulance service, welcoming hospital environment, proper pain management and listening to their questions. Therefore, there is need to improve the care given to maternity and appropriate strategy should be designed to address the unmet needs of mothers delivered in the hospital.

Background: Work force is a crucial component of health services and health systems necessary to achieve Primary Health Care (PHC) and Universal Health Coverage (UHC). Ethiopia faces health workforce challenges with regard to evidence based health work force planning. Even though Ethiopia is constantly reforming its health system with the primary aim of having the right number of health workers in the right place at the right time to meet the population’s health needs, the health facilities in the country are staffed using perceived needs. The Workload Indicators of Staffing Need (WISN) tool developed by the World Health Organization is not used to determine staffing requirements for facilities. Rather the traditional method of health worker to population ratio is used instead. But the traditional method of staffing health workers does not satisfy the staffing need of the health facilities as well as the health service need of the community. Therefore this study was assumed for policy recommendation on the use of Workload methods of staffing need (WISN) for regional health bureau based on WISN results of midwives needed for Asrade zewude memorial Hospital north west Ethiopia.Methods: WISN model was used to determine the gaps or excess and workload pressure in midwives at Asrade Zewude Memorial primary hospital, north west Ethiopia. Midwives were selected as priority cadre based on current staffing problems. Available working time was determine using national calendar, personnel files and HR regulatory documents. Workload components of midwives were determined by establishing expert working group comprised of midwives hospital performance monitoring and evaluation unit staff and human resources management staff. Two hours detail training was given for expert working group using WHO WISN manual. The data that has been used by expert working group were; detail midwives job descriptions obtained from human resources management, annual service statistics obtained from hospital performance monitoring and evaluation unit and midwifery service activities and support activities were listed and explained by head of hospital midwifery service unit. We also cross check workload data from July 1, 2019–June 30, 2020 G.C for midwifery department using health service activity data of district health information system (DHS2)data base.Results: The WISN analysis showed that a shortage of five midwives with WISN ratio of 0.8 and high workload pressure among 20 midwives at Asrade Zewude Memorial primary hospital north west Ethiopia.Conclusion and Recommendation: This study showed that midwives at the study area were doing their routine work under high workload pressure by covering the additional five midwives' position. With this working condition, it may be hard to achieve primary health care (PHC) and universal health coverage (UHC). Therefore regional health bureau should institutionalize WISN method for staffing need to objectively employ five additional midwifery professionals so as to achieve health development goals set by the hospital.