Patients' Perception Of The Quality Of Maternal Health Care Services At The Shai Osudoku District Hospital, Dodowa

Abstract

Background: Ghana has made significant progress in maternal health over the past decades but failed to attain Millennium Development Goal 5 by the end of 2015 that sought to reduce the maternal mortality ratio (MMR) by three-quarters between 1990 and 2015, and achieve universal access to reproductive health by 2015. Consequently, nearly 358 Ghanaian women per 100,000 live births die annually from preventable (or at least reducible) maternal deaths in spite of massive investments by government and development partners. The challenges in this respect have not only been shortage of medicines, healthcare professionals, and healthcare infrastructure, but also lack of quality improvement (QI) support as the bottlenecks of maternal care in Ghana. Therefore, these do not only put pregnant women at risk for morbidity and mortality but also culminates in poor quality of maternal care rendered in health facilities. While efforts have been made by researchers to examine the issue of service quality especially in the area of maternal care, there have been little or no quality studies that examine the quality of maternal care in Ghana's context using a coherent theoretical framework. The study therefore sought to assess maternal health service quality at the Shai-Osudoku District Hospital (SODH) in the Greater Accra Region, a hospital well known for its 'zero tolerance for maternal mortality' . Methodology: A quantitative method using cross-sectional survey design was employed to recruit a sample of 195 patients seeking maternal health service at the Shai-Osudoku District Hospital. Patients were recruited using a consecutive sampling technique and the data analysed using Statistical Package for Social Science (SPSS version 20). In addition to descriptive summary statistics, inferential analysis including the paired t-test and regression models were used to draw conclusions from the data. Results: The overall expectation of patients of quality maternal care was as high as 91.3% (95% CI: 90.0%-92.6%) whilst they perceived or experienced 91.2% (95% CI: 89.6%-92.8%)of service quality. Inferential analysis showed no significant difference between the composite of patients' expectations of quality and the level they experienced or perceived even though expectations were missed by 2.7% (p = 0.251). Patients had a high level of satisfaction with the quality of maternal services at 86.2% which is 15 percentage points higher than the reported national average. Tangibility dimension is high point (91.2%) of patient satisfaction whilst responsiveness (staff conununication and promptness of service) was the weakest link (89.1%). Conclusion: Patients expectations of maternal care quality at the Shai-Osudoku District Hospital are largely met and hence patients' satisfaction rates are high. However, Management still needs to address issues of staff attitude and respect for patients especially at the history taking points of maternal services at the hospital as these were the weakest links in the patient satisfaction ratings.