Women’s satisfaction with maternity experience at a regional hospital in Swaziland: A cross sectional survey

Zwakele Z Tfwala, Nai-Wen Kuo


Clinical care during labor and childbirth is important, however understanding women’s preferences and experiences have become more important in assessing quality health care delivery and maternity services utilization. Knowledge on women’s satisfaction will be one of the important steps towards solving maternal and child health problems faced in Swaziland. The aim of the study was to determined maternity experiences and women’s demographic characteristics that affect perceived satisfaction with maternity care at a regional hospital in Swaziland. A cross sectional survey using structured interview questionnaire was used to obtain data from 198 women who had a normal childbirth during their postnatal hospital stay. One-way ANOVA and t-test were used to examine association between variables and stepwise multiple linear regression analysis was conducted to identify predictors of satisfaction. The final model indicated that respecting women’s description of pain/discomfort, staff kindness, gender of birth assistant, never being alone during labor and woman’s education level determined satisfaction with maternity experience, explaining 44.6% of the variation in maternity satisfaction (F= 30.932, p <.001). The study findings show the importance of provider related factors (interpersonal aspect of care, gender of provider) and consideration of woman’s education on satisfaction with care during intrapartum and postpartum. (Afr J Reprod Health 2021; 25[3]: 94-104).

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Christiaens W and Bracke P. Assessment of social

psychological determinants of satisfaction with childbirth in cross-national perspective. BMC Pregnancy and childbirth, 2007; 7(1):1-12.

Jackson JL, Chamberlin J and Kroenke K. Predictors of

patient satisfaction. Social Science and Medicine 2001; 52(4): 609-620

Ross-Davie CM, Cheyne H and Niven C. Niven.

Measuring the quality and quantity of professional intrapartum support: testing a computerised systematic observation tool in the clinical setting. BMC pregnancy and childbirth, 2013; 13(1): 1-12.

Matejic B, Milicevic M S, Vasic and Djikanovic B.

Maternal satisfaction with organized perinatal care in Serbian public hospitals. BMC pregnancy and childbirth, 2014; 14(1): 1-9.

World Health Organization, Client satisfaction

evaluations, World Health Organization, 2000: Geneva. Retrieved January 28, 2013 from www.emcdda.europa.eu/.../att_5868_EN_6_client_satisfaction_evaluation

Sawyer A, Ayers S, Abbott J, Gyte A, Rabe H and Duley

A. Measures of satisfaction with care during labour and birth: a comparative review. BMC pregnancy and childbirth, 2013; 13(1):1-10.

Government of Swaziland, Multiple Indicator Cluster

Survey (MICS): Monitoring the situation of children, women and men. 2010: Mbabane

UNICEF, Levels and trends of child mortality. 2012: New

York. Retrieved 3 February 2013 from http://www.unicef.org/videoaudio/PDFs/UNICEF_2012_child_mortality_for_web_0904.pdf

Central Statistical Office (CSO) [Swaziland] and Macro

International Inc., Swaziland Demographic and Health Survey. 2006-07 Mbabane.

Waldenstrom U, Rudman A and Hildingsson I.

Intrapartum and postpartum care in Sweden: women's opinions and risk factors for not being satisfied. Acta obstetricia et gynecologica Scandinavica, 2006: 85(5): 551-560.

Sitzia J. and Wood N. Patient satisfaction: A review of

issues and concepts. Social science & medicine, 1997; 45(12):1829-1843.

Hodnett ED. Pain and women's satisfaction with the

experience of childbirth: a systematic review. American journal of obstetrics and gynecology, 2002; 186(5): S160-S172.

Bleich SN, Ozaltin E and Murray CJL. How does

satisfaction with the health-care system relate to patient experience? Bulletin of the World Health Organization, 2009; 87: 271-278.

Aldana JM, Piechulek H and Al-Sabir A.. Client

satisfaction and quality of health care in rural Bangladesh.

Bulletin of the World Health Organization, 2001; 79: 512-517.

Ith P, Dawson A and Homer C. Women's perspective of

maternity care in Cambodia. Women and Birth, 2013; 26(1): 71-75.

Alrubaiee L and Alaa’ida F. The mediating effect of

patient satisfaction in the patients' perceptions of healthcare quality-patient trust relationship. International Journal of Marketing Studies, 2011; 3(1): 103.

Miller S, Cordero M, Coleman AL, Figueroad J, Brito-

Anderson S, Dabagh R, Calderon V, Caceres F, Fernandez A J and Nunez M. Averting maternal death and disability Quality of care in institutionalized deliveries: the paradox of the Dominican Republic.International Journal of Gynecology & Obstetrics, 2003; 82(1): 89-103.

Bjertnaes OA and Iversen HH. User-experience surveys

with maternity services: a randomized comparison of two data collection models. International Journal for Quality in Health Care, 2012; 24(4): 433-438.

Goldberg H. Informed decision making in maternity care.

The Journal of perinatal education, 2009; 18(1): 32-40.

Gungor I and Beji NK. Development and psychometric

testing of the scales for measuring maternal satisfaction in normal and caesarean birth. Midwifery, 2012; 28(3):348-357.

Government of Swaziland, Improving the Quality of

Maternal and Neonatal Health Services in Swaziland: A Situational Analysis, 2011. Ministry of health, Mbabane.

Duff L, Lamping DL and Ahmed LB. Evaluating

satisfaction with maternity care in women from minority ethnic communities: development and validation of a Sylheti questionnaire. International Journal for Quality in Health Care, 2001;13(3):215-230.

Gamble J, Creedy DK, and Teakle B. Women's

expectations of maternity services: a community-

based survey. Women and Birth, 2007; 20(3):115-120.

Hulton LA, Matthews Z and Stones RW. Applying a

framework for assessing the quality of maternal health services in urban India. Social science & medicine, 2007; 64(10):2083-2095.

Shafiei T, Small R and Mclachlan H. Women's views and

experiences of maternity care: a study of immigrant Afghan women in Melbourne, Australia. Midwifery, 2012; 28(2): 198-203.

Bazant ES and Koenig MA. Women's satisfaction with

delivery care in Nairobi's informal settlements. International Journal for Quality in Health Care, 2009; 21(2):79-86.


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