Levels of Person Centered Antenatal Care among Pregnant Women in Public and Private Health Facilities in Western Hararghe Zone, Ethiopia: An Institution Based Comparative Mixed Method Study Design

Abstract

Background Person centered Antenatal Care (PCANC) is a component of quality care that is essential to enable maximize health outcomes. It is believed to be one of the reasons why private health facilities have higher quality than public health facilities. However, in Ethiopia, there is a little study that assesses and compares the level of person centered antenatal care among pregnant women in public and private health facilities. Objectives: To assess and compare the level of person centered antenatal care among pregnant women attending antenatal care in public and private health facilities in the Western Hararghe zone, Oromia region, Ethiopia, 2020. Methods:- An Institution Based Comparative Mixed Method Study Design was conducted among pregnant women in the Western Hararghe zone, Ethiopia from September 01–October 02, 2020. A multistage stage sampling technique was used to obtain 340 pregnant women (170 from public facilities and 170 from private facilities). The data were entered into Epi–data version 4.4 and analyzed using SPSS version 27. A comparison of categorical and continuous variables was done using an independent t–test and Chi–square test respectively. All comparisons were considered to be significant at a p–value of < 0.05. Qualitative data was analyzed by manually. Results: The overall PCANC percentage mean score was significantly higher in private health facilities (73.7%; 95% CI: 70.5–77.1%) compared to public facilities (59.7%; 95% CI: 56.05–63.5%) (P<0.001). Private facilities had higher percentage mean score than public ones in effective communication (71.4% vs. 56.3%), respect and dignity (85.2% vs. 71.2%), and supportive care (70.1% vs. 59.2%). Qualitative findings further highlighted better interpersonal communication in private facilities. Conclusion: This study highlights significant disparities in the PCANC between private and public health facilities, with private facilities better in effective communication, respect, dignity, and supportive care. Qualitative findings further underscore better interpersonal communication in private settings. Addressing the disparities in person-centered antenatal care between private and public health facilities is crucial to achieve equity and quality of antenatal care. Keywords: Person centered care, antenatal care, pregnant women, private health facilities, public health facilities, Ethiopia