Client satisfaction and Competency of Healthcare Providers with the services of BRAC Maternity Centres – A Cross Sectional Study

Abstract

Background Client satisfaction and competency of the healthcare providers are key areas to ensure good health service delivery anywhere. The objective of this study was to understand the competency of the healthcare providers of BRAC maternity centres (BMC) in rural areas of Bangladesh and acceptance of their services at client level. Methods It was a cross-sectional exploratory mixed method study. For exploring client satisfaction and expected services of the clients, 2810 married women, aged 15-44 years with a delivery outcome within one year of interview, were included in the survey. In addition, 12 observations, and19 in-depth interviews of patients and their attendants were used for collecting information on competency of the midwives and Community Skilled Birth Attendants (CSBAs) from four upazillas in Bangladesh. The BMC in Mithapukur was functioning for two years preceding the survey, whilst rest of the three were established before two months of the survey. For this reason client satisfaction information was collected only from BMC in MIthapukur. On the other hand, information on competency of midwives and CSBAs were collect from all BMCs. Results Mean age of the respondents was around 24 years and more than 96% were housewives. All facilities were well equipped to provide maternity services. We found that more than 92%, 91% and 87.5% of the beneficiaries of BMC in Mithapukur were satisfied with the antenatal care (ANC) check-up, normal delivery and episiotomy services. For all other centres, most of the clients expected caesarean section facilities, availability of doctors and financial support from the centres. In terms of competency, the midwives and CSBAs were satisfactorily competent to provide all required services. Conclusion Overall, the results suggest the BMC holds competent workforce and similar service delivery strategies can be replicated in poor resource settings and BMCs to ensure quality care and trust in the patients for healthcare service utilisation. Keywords: Antenatal care, delivery care, postnatal care, neonatal care, competency, midwife, community skilled birth attendant, client satisfaction