Study Design and period
A facility based cross-sectional study was conducted at Gondar University specialized and teaching hospital from November 1 to 30 2018.
Study Area
Gondar University Referral Hospital is found in Gondar City administration, 772 kilometers away from Addis Ababa, the capital city of Ethiopia and 185 kilometers away from Bahir Dar the capital city of Amhara regional state. According to the projection from national census of 2007 the total population of Gondar City Administration, is estimated to be 360,600 (9). There were estimated to be 83,010 of women with reproductive age group and among these 13,342 women are expected to get pregnant which considered to give birth in the hospital annually.
Study population
Selected mothers who visited Gondar university specialized teaching hospital for delivery service during data collection period were taken as study population. Post-natal mothers who were sick and unable to communicate were excluded from study.
Sample Size Determination and Sampling Procedure
The sample size was determined by using a single population proportion formula by considering assumptions 95% of CI, 4% of marginal error, 10% of non-response rate and proportion of mothers satisfaction Felege Hiwot hospital delivery care service 74.9% (10). Finally, 496 sample size was estimated.
To recruit the final 496 study participants from delivery service received mothers, systematic random sampling method with k interval of 2 were employed. To obtain the k interval of sampling the previous months’ average number of delivery service received mothers and the estimated sample size were considered. The first client was selected by simple random sampling among the first two clients.
Study Variables
Maternal satisfaction with delivery services was dependent Variable; whereas Socio-demographic and economic factors (Age, religion, marital status, educational level, residence and occupation), Health care facility factor (distance), Obstetrics factors (Parity, planned status of the pregnancy, time of labor for current delivery (night/day) and ANC follow-ups ) and Respectful and non-abuse care (Physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination and abandonment of care) were the independent variables of the study.
Operational Definition
Maternal Satisfaction with Delivery Service: Individuals scored 75 % and more from sixteen 16 items of Client Satisfaction Likert scale questions were categorized as “satisfied”. Individuals scored below 75 % from 16 items of Client Satisfaction Likert scale questions, are categorized as “unsatisfied”. (11-13).
Respectful Materiality Care (RMC): if respondents not experienced at least one form of disrespect and abuse during delivery services (14).
Data collection tools and procedure
Data was collected using structured, an exit interview questionnaire having four parts, the first part containing the socio demographic characteristics of delivering mothers, the second part obstetric characteristics of delivering mothers, the third part health facility factors. The fourth parts containing delivery service satisfaction related questions were adopted and modified from different literatures (8, 15-18) and presented using a 5-Likert scale (1-very dissatisfied, 2-dissatisfied, 3-neutral, 4-satisfied, and 5-very satisfied). The fifth part containing respectful and non-abuse care related questions were adopted from different literatures (14, 19). The first draft of the English questionnaire was translated to Amharic local language by language expert translators then back to English language to check for consistency. Two Midwives data collector were recruited and trained for 2 days on the objectives of the study, method and the approaches they employee to collect data.
Before starting the actual survey, the questionnaire was pre-tested on 24 postnatal mothers in Gondar Zuria district health centers. Throughout the course of the data collection, interviewers were supervised at each site, regular meetings were held between the data collectors and the principal investigator together in which problematic issues arising from interviews which was conducted and mistakes found during editing was discussed and decisions was made. The collected data was reviewed and checked for completeness before data entry; the incomplete data was discarded.
Data Processing and Analysis
Each questionnaire was checked manually, coded and entered into EPI info version 7 statistical software and exported to statistical package of social science (SPSS) Version 20.0 software for analysis. The descriptive results expressed using summary statistics such as mean, standard deviation, frequency, and percentage. A binary logistic regression model was fitted to determine the effect of various factors with maternal satisfaction. Variables with a p-value less than 0.2 in bivariate analysis were entered into multivariable logistic regressions to determine factors independently associated with maternal satisfaction. The odd ratio with 95% confidence interval and p-value less than 0.005 were used to determine factors independently associated with maternal satisfaction.