Sociodemographic characterstics of participants
A total of 403 postnatal mothers participated in this study with 96.4% response rate. Among these mothers, 274 (68%) were from urban. Two hundred seven (51.4%) of the mothers were aged between 25 and 34 years. The mean age was 28 years (+6 SD). Almost all 388 (96.3%) of the mothers were engaged at the time of the survey. Three hundred thirty-nine (84.1%) mothers were at least can read and write. Ninety-five(23.6%) mothers were housewife by teir occupation. Eighty-five (21.1%) of the mothers were from a family of greater than five members. Twenty-three (5.7%) of the mothers gave more than five births(Table 1).
ANC related information
The majority, 383 (95%) of mothers knew about ANC and 373 (92.6%) of the mothers had access to ANC care services. Three hundred seventy-two (92.3%) of the mothers who gave birth were at ANC follow-up for the current pregnancy. Two hundred nineteen (58.9%) of the mother who had ANC follow-up for the current pregnancy got the services from University of Gondar teaching and referral hospital and 206 (55.4%) of the mothers reported that each visit took more than twenty minutes. One hundred fifty-five (41.7%) of the mothers followed more than four times (Table 2).
Labor and delivery related services
The vast majority, 318 (85%) of the mothers deliverd their previous baby through spontaneous vaginal delivery (SVD) and 230 (57.1%) of the mothers reported that they gave birth at hospitals for their previous pregnancy. Two hundred ten (52.1%) mothers came to hospital by their own plan. Two hundred fifteen (53.3%) of the mothers reported that they waited for 10 or below minutes to get services. Three hundred eighty-seven (96%) of the mothers were seen by doctors during delivery and the labor of 381 (94.5%) mothers lasted more than 3 hours. Three hundred eighty(94.3%) mothers gave alive birth and 76 (18.9%) of the new borne babies were under weight (Table 3).
Mothers’ satisfaction on delivery care service
Mothers’ satisfaction on delivery care services was measured using 31 questions categorized under five categories: 10 questions under health care services; 6 under physicians’ communication; 5 under physicians’ attitude, 4 under privacy; and 6 under sanitation categories. Time spend with health care service providers (379/94%) and medical care received (377/93.5%) were areas where the highest proportion of mothers satisfied under the health care service category(Figure 1). The way health care providers explain clients health condition (358/88.8%), information about procedures(355/88.1%) and care providers’ devotion to listen clients’ worry (355/83.6%) were areas where the highest proportion of mothers satisfied under the physicians’ communication category (Figure 2). Doctors’ respection(363/90.1%), nurses’ respection(193/47.9%) and the way staffs accept clients’ opinion(193/47.9%) were areas where the highest proportion of mothers satisfied under the physicians’ attitude category (Figure 3). Availability of separate delivery/examination rooms(260/65.3%) and gender mix of care providers (260/64.5%) were areas where the highest proportion of mothers satisfied under the privacy category (Figure 4). Facilities’ cleanliness (279/69.2%) and cleanliness of waiting areas(256/63.5%) and were areas where the highest proportion of mothers satisfied under the sanitation category (Figure 5). Physicians’ communication (315/78.2%), health care services (264/65.5%), and physicians’ attitude (259/64.3%) were areas where the highest proportion of mothers satisfied. On the otherhand, the highest proportion of mothers (223/55.3%) were dissatisfied on sanitation condition (Figure 6). Overall, 264 (65.5%) of the mothers were satisfied on delivery services and the the rest 139 (34.5%) mothers were dissatisfied.
Factors associated with mothers’ level of satisfaction on delivery services
Table 4 shows factors associated with mothers’ level of satisfaction on delivery services. Level of education, ANC follow-up in the current pregnancy, waiting time, qualification of care providers, duration of labor, and pregnancy outcomes were selected to the multivariable binary logistic regression by the univariable binary logistic regression. Maternal satisfaction on delivery was statistically associated with level of education of the mothers, ANC follow-up in the current pregnancy, and waiting time.
This study revealed that literate mothers were more dissatisfied than illiterate mothers. The odds of satisfaction was 71% less among mothers whose education level was diploma and above compared with mothers who didn’t attend formal education [AOR = 0.29, 95% CI = (0.13, 0.66)]. Mothers who attended secondary education and/or primary education were less likely to be satisfied compared with illiterate mothers[AOR = 0.42, 95% CI = (0.20, 0.90)].
Maternal satisfaction on delivery services was significantly associated with ANC follow-up in the current pregnancy. The probability of being satisfied was 4.47 times more likely to be higher among mothers who had ANC follow-up compared with their counterparts [AOR = 4.47, 95% CI = (1.77, 11.27)].
The current study depicted that waiting time was associated with maternal satisfaction on delivery services. Mothers who waited for 10 and/or below minutes were 1.85 times more likely to be satisfied compared with mothers who waited for more than 10 minutes to get services [AOR =1.85, 95% CI = (1.19, 2.88)].
Discussion
The present study determined the level of maternal satisfaction on delivery services at the University of Gondar teaching and referral hospital, northwest Ethiopia. The overall satisfaction level of mothers was found to be 65.5% (95% CI = 60.1 – 70.2%). The current level of satisfaction was in line with the reports of other similar studies in Amhara region (61.9%)(15) and South Ethiopia (67.9%)(17); The level of maternal satisfaction reported in this study was lower than the findings of other similar studies in Debremarkos (81.7%)(16); in Assela (80.7%)(18); in Bure (88%)(19); in Bahir Dar(74.9 %)(20); in Hawassa (87.7%)(21); in Wolayta zone(82.9%)(22) in Arba Minch(90.2%)(23) and in Nepal(89.88%)(24). The Current level of maternal satisfaction was also higher than the findings of other studies in Iran (59.5 %)(25) and Sri Lanka(29.6%)(26). The difference in level of maternal satisfaction across studies might be due to variation in health institutions quality and health care providers competency, behavior and approach.
This study showed that education status of mothers was found to be significantly associated with maternal satisfaction on delivery care rervices. Mothers who attended formal education were dissatisfied. Other similar studies also reported the inverse relation of satisfaction and educational status of mothers(18, 19, 21, 23). The probable reason might be due to the fact that educated mothers expect and demand better health care service quality. Moreover, educated mothers might know service quality standards and might compare the services they received with the standard(24).
This institution based cross-sectional study depicted that maternal satisfaction on delivery services was significantly associated with ANC follow-up which is inline with the findings of other studies (15, 18, 23, 27). ANC follow-up might give mothers a continuum of care from the ante natal to the post-partum period which will grant mothers all the necessary information about birth preparedness and information related to the current pregnancy(28).
This study found that waiting time to get health care service was the other statistically significant variable with maternal satisfaction. Mothers who waited shorter time to get service were more satisfied. This finding is also supported by other studies(15, 18, 23). This might be due to the fact that providing health care services with no delay can prevent complication prolonged pain and clients boringness(29, 30).