Institutional factors influencing women's perception of quality of intrapartum care in Naivasha County Hospital labour ward, Kenya

Abstract

Aims: A survey carried out in the maternity centre of a Kenyan county hospital sought to evaluate the institutional factors influencing women's perception of quality of intrapartum care. Methods: This cross-sectional quantitative and qualitative study involved 195 postpartum mothers, who were randomly sampled. A questionnaire, a focus group discussion and a key informant interview were used to collect data. Findings: The study indicated that there was a positive relationship between women's perceptions of quality of intrapartum care and institutional factors, such as cost of services and comfort in waiting rooms (P = 0.007 and 0.025, respectively). Residing near a hospital was also associated with a positive perception of the quality of intrapartum care. Conclusions: This study reveals that it is important to provide an affordable and accessible environment during childbirth to improve the women's perception of quality of care provided during this period. This study's findings have implications in the design of maternity centres and the implementation of free maternity services in Kenya.

Quality intrapartum care expectations and experiences of women in sub-Saharan African Low and Low Middle-Income Countries: a qualitative meta-synthesis

“… 30 women (postnatal) 16 Madula et al (2018) [ 38 ] Malawi Qualitative study in depth interviews To examine the nature of communication in the maternity ward, and to identify facilitators and barriers to healthcare provider-patient communication 30 women (recruited from antenatal or postnatal clinic) 17 Mselle et al (2019) [ 39 ] Tanzania Qualitative study in depth interviews and focus group discussions The experiences of mothers and fathers in relation to mistreatment during childbirth in Tanzania. 13 women (postnatal) 18 Malachi et al (2016) [ 40 ] Kenya Qualitative part of a bigger mixed methods study In-depth interviews and key informant interviews To evaluate the institutional factors influencing women’s perception of quality intrapartum care. women in postnatal period (number of women participated in the FGD session is not provided) 19 Debela et al (2021) [ 41 ] Ethiopia Qualitative part of a bigger mixed methods study In-depth interviews To explore underlying determinants of maternal satisfaction towards institutional delivery care among mothers who gave birth in public health facilities 36 women 20 Burrowes et al (2017) [ 42 ] Ethiopia Qualitative study In-depth interviews Women’s experiences of midwifery care during labor and to explore midwives’ understandings of patients’ rights and patient-centered care and their experiences with patient abuse and disrespect; 23 women 21 Bohren et al (2017) [ 29 ] Nigeria Qualitative study In-depth interviews and focus group discussions To explore women and providers’ experiences and perceptions of mistreatment during childbirth …”

“…Women emphasised the need to have clean facilities (especially delivery wards and bathrooms) with sunlight, access to water, electricity, and sanitation services, adequate beds, uncrowded wards, adequate space and curtains for privacy, and access to bed nets [ 21 , 30 , 32 ]. There were also descriptions of negative experiences related to the inadequate physical environment including crowded rooms [ 29 , 30 , 40 , 45 ] insufficient beds [ 29 , 30 , 36 , 39 , 50 ], lack of access to water and food [ 21 , 50 ], dark labour rooms with no natural sunlight [ 21 , 30 ] and unclean premises [ 30 , 43 ]. [A]fter delivery there is a room we were taken to sleep, there was no light, no windows, no beddings and we were to stay there feeling cold till morning.…”

Quality intrapartum care expectations and experiences of women in sub- Saharan African Low and Low Middle-Income Countries: A qualitative meta- synthesis

“…Women emphasized the need to have clean facilities (especially delivery wards and bathrooms) with sunlight, access to water, electricity, and sanitation services, adequate beds, uncrowded wards, adequate space and curtains for privacy, and access to bed nets (22,23,36). There were also descriptions of negative experiences related to the inadequate physical environment including crowded rooms (30,36,41,49) insu cient beds (26, 30,34,36,42), lack of access to water and food (22,26), dark labour rooms with no natural sunlight (22,36) and unclean premises (29,36).…”