Quality of Antenatal Care: Comparison between Secondary and Tertiary Health Facilities in Ibadan, Nigeria

Abstract

Background: Patient satisfaction is related to the quality of services received and the extent to which specific needs are met. Satisfied patients are likely to come back for the health services and recommend it to others. Objective: To assess and compare patients' satisfaction with the quality of prenatal/antenatal care (QPC) services received at a tertiary and secondary health facility in Ibadan, Nigeria. Methods: A comparative cross sectional study used an interviewer administered questionnaire to assess and compare the quality of antenatal care among women who had antenatal care and delivered live baby in two government health facilities-Adeoyo Maternity Hospital (secondary health facility) and University College Hospital (tertiary health facility). A total of 500 women were interviewed within 48 hours post delivery and data obtained was analyzed with SPSS version 20. Results: The mean age was 29.7 (SD = 4.95) years. About half of the respondents had more than four antenatal visits, almost two-thirds (61.4%) were primipara, and 55.6% delivered per vagina. Almost all (98.4%) the women were very satisfied with the QPC received while a little above half (54.0%) received high QPC. Health facility and mode of delivery were found to be significantly associated with the satisfaction of the QPC. Factors predicting high QPC comparing the tertiary and secondary health facility are "availability" (OR = 0.341, 95%CI = 0.173 -0.672) and "support and respect" (OR = 5.599, 95%CI = 3.621 -8.659) of health care workers. Conclusion: Though the women were very satisfied with the QPC rendered barely half of them reported high quality QPC and this should be the ultimate aim. Promoting and ensuring high quality of antenatal care in our hospitals will improve the antenatal attendance and hospital deliveries with subsequent reduction in maternal morbidity and mortality.

Clients’ Assessment of Quality of Antenatal Care Services at Federal Teaching Hospital Abakaliki, Nigeria: Understanding Key Role of Health Providers

“…This has huge implications for improving maternal health in Nigeria and it may be an indication that the expectations of the women were met during ANC. There has been an opinion that high quality ANC will encourage its utilization by women and this will make it possible that the women will prefer to deliver in the same health facilities [28]. This is of relevance as utilization of formal health facilities for delivery services in Nigeria is poor as only 36% of births take place in health facilities and this is worse in rural areas [5] and in primary health centers [9].…”

“…Satisfaction with prenatal care has been found to be an important determinant of its utilization [40]. Also such quality ANC services will encourage utilization of health services for delivery hence capable of reducing the high maternal morbidity and mortality in Nigeria [28].…”

Palliative care for people living with HIV/AIDS: Factors influencing healthcare workers’ knowledge, attitude and practice in public health facilities, Abuja, Nigeria

“…The type of health facilities was significantly associated with knowledge of palliative care Participants in secondary facilities are more likely to score lower on the knowledge scale of palliative care compared to their contemporaries in tertiary health facilities. This may be because secondary facilities do not have sufficient healthcare workers [23] or those with sub-specialties such as providing palliative or hospice care as compared to tertiary facilities [24]. Demand from workload among secondary health facilities staff could also result into reduced attention on palliative care area.…”

“…It is expected that knowledge of palliative care would be higher in tertiary facility being a teaching hospital and a referral centre. This could be attributed to more academic activities that take place within the tertiary health facilities and they are also generally better equipped than secondary health facilities in terms of service delivery [23]. On the other hand, this finding may simply relates to the knowledge possessed by the individuals rather than the influence of the facilities.…”