Assessing Person- Centered Maternity Care at the LEKMA Hospital

Abstract

Many women lose their lives annually during childbirth and a high proportion of the deaths happen in Sub Saharan Africa. Consequently, maternal mortality remains a pressing issue and poor person- centered maternity care contributes both directly and indirectly to it. Person- centered Maternity Care (PCMC) is defined as maternity care that is deferential and responsive to the needs, values and preferences of prospective mothers. Growing evidence suggests that quality of maternal care received by women plays an important role in identifying complications during labour and childbirth in facility based deliveries thus decreasing maternal mortality and morbidity significantly. Despite the positive effect of PCMC on maternal outcomes, there is inadequate literature on the subject. The main objective of this study was to assess the levels of PCMC in the LEKMA Hospital. The specific objectives were to identify the proportion of women receiving poor PCMC, the domain of PCMC in which women record low scores and the factors influencing PCMC using a recently developed PCMC scale. This study was a facility- based cross sectional study. The sample size was calculated to be one hundred and ninety- two women. Structured questionnaires which included the PCMC scale were used to collect data and were collected, cleaned, coded and keyed into Microsoft Excel after data collection. Scores obtained by women from the PCMC scale were summed up and categorized into Low (0-26), Moderate (27-52) and High (53-78). The raw data was then exported to Stata Version 15 for analysis. Descriptive statistical analysis (mean and standard deviation for quantitative continuous variables and proportions for categorical variables) was performed to describe mother-related factors that influence the levels of PCMC received. Chi Square test was used to compare proportions of low or high PCMC scores among various groups of women (example age groups) to determine the associations between the dependent and independent variables. The binary logistic regression model was used to determine which demographic and individual level characteristics as well as health facility factors were most significant in influencing the level of PCMC received. One hundred and ninety- two women participated in the study out of which only one recorded a low PCMC score. The Dignity and Respect domain received the lowest mean score and the factors that were found to influence PCMC significantly (p< 0.05) were uninterrupted water supply, uninterrupted power supply and the level of overcrowding in the wards. In conclusion LEKMA Hospital provides good PCMC to prospective mothers however, attention should be paid to Respect and Dignity as well as infrastructure to reduce disparities in PCMC. The PCMC scale also had good reliability (Cronbach alpha = 0.88) and can be used across various contexts to determine quality of maternity care received by women.