Maternal satisfaction with postnatal home visitation services by community health nurses in Ashanti Region, Ghana: A cross-sectional correlational study

Yvonne Agyeman-Duah, Million Bimerew


Efforts have been made to improve maternal and child health care globally, with a focus on promoting postnatal home visitation care. Despite the known significance of postnatal home visits, concerns still exist regarding mothers’ satisfaction with home visitation care. This study examined maternal satisfaction with postnatal home visitation care in the Ashanti Region. A crosssectional correlational study design was used to gather data from the study participants using the Jipi’s questionnaire to assess maternal satisfaction with healthcare. Ten (10) district hospitals were randomly selected from 27 district hospitals in the region. A sample size of 170 postnatal mothers were then selected randomly from the 10 districts hospitals according to proportion of mothers at each facility. SPSS version 25 was used to analyse the data using descriptive statistics and Chi-square at a p-value = 0.05. The results indicated that the mothers were satisfied with the overall home visitation services, yet, showed dissatisfaction towards some specific postnatal care, including the quality of information on maternal care and support rendered by the CHNs regarding the care of the newborn during their visit. The satisfaction levels of mothers with these services are high, yet there are still opportunities for improving them by addressing specific challenges and tailoring these services to the diverse needs of postnatal mothers. In conclusion, CHNs’ work during postnatal period is essential in promoting the health of both the baby and the mother. (Afr J Reprod Health 2024; 28 [5]: 13-21).

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World Health Organization. WHO technical consultation on postpartum and postnatal care. World Health Organization; 2010. 2. Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, Fat DM, Boerma T, Temmerman M, Mathers C and Say L. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet. 2016;387(10017):462–74. 3. World Health Organization. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2019; 4. World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division: executive summary. 2023; 5. Boafor TK, Ntumy MY, Asah-Opoku K, Sepenu P, Ofosu B and Oppong SA. Maternal mortality at the Korle Bu Teaching Hospital, Accra, Ghana: A five-year review. Afr J Reprod Health. 2021;25(1):56–66. 6. World Health Organization. Standards for improving quality of maternal and newborn care in health facilities. 2016; 7. Annan GN and Asiedu Y. Predictors of Neonatal Deaths in Ashanti Region of Ghana: A Cross-Sectional Study. Adv Public Health;2018:e9020914. 8. Owen MD, Colburn E, Tetteh C and Srofenyoh EK. Postnatal care education in health facilities in Accra, Ghana: perspectives of mothers and providers. BMC Pregnancy Childbirth. 2020;20(1):664. 9. Yawson AE, Awoonor-Williams JK, Sagoe-Moses I, Aboagye PK, Yawson AO, Senaya LK, Bonsu G, Eleeza JB, Agongo EEA and Banskota HK. Bottleneck analysis approach to accelerate newborn care services in two regions in Ghana: implications for national newborn care. Public Health. 2016;141:245– 54. 10. Yonemoto N, Dowswell T, Nagai S and Mori R. Schedules for home visits in the early postpartum period. EvidBased Child Health Cochrane Rev J. 2014;9(1):5–99. 11. Awoonor-Williams JK, Sory EK, Nyonator FK, Phillips JF, Wang C and Schmitt ML. Lessons learned from scaling up a community-based health program in the Upper East Region of northern Ghana. Glob Health Sci Pract. 2013;1(1):117–33. 12. Tully KP, Stuebe AM and Verbiest SB. The fourth trimester: a critical transition period with unmet maternal health needs. Am J Obstet Gynecol. 2017;217(1):37–41. 13. Womersley K, Ripullone K and Hirst JE. Tackling inequality in maternal health: Beyond the postpartum. Future Healthc J. 2021;8(1):31–5. 14. Martin A, Horowitz C, Balbierz A and Howell E A. Views of women and clinicians on postpartum preparation and recovery. Maternal and Child Health Journal. 2014;18(3), 707–713. 15. Gerchow L, Burka LR, Miner S and Squires A. Language barriers between nurses and patients: A scoping review. Patient Educ Couns. 2021;104(3):534–53. 16. Martin A, Horowitz C, Balbierz A and Howell EA. Views of women and clinicians on postpartum preparation and recovery. Maternal and Child Health Journal, 2014;18(3), 707–713. 17. Avudaiappan S and Annamalai N. A study to assess maternal satisfaction with postnatal care services among mothers admitted at postnatal ward in Government Rajaji Hospital, Madurai. Journal of Evidence Based Medicine and Healthcare, 2020; 7(12), 588–592. 18. Sakala B and Chirwa E. Factors affecting utilization of postnatal care among mothers: A case of Ntchisi district in Malawi. Malawi Medical Journal.2019; 31(1), 7–14. 19. Budu E. Predictors of home births among rural women in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey. BMC Pregnancy Childbirth. 2020;20(1):523. 20. Ghana Statistical Services. Ghana 2021 Population and Housing Census General Report. Ghana Statistical Service Accra, Ghana; 2021. 21.The Ghana Demographic and Heath survey. Key indicators report (2022) 22. Awoonor-Williams JK, Phillips JF and Bawah AA. Catalyzing the scale-up of community-based primary healthcare in a rural impoverished region of northern Ghana. Int J Health Plann Manage. 2016;31(4):e273– 89. 23. Cochran WG. 1963Sampling Techniques. John Wiley and Sons, New York; 23. Edvardsson D, Watt E and Pearce F. Patient experiences of caring and person-centredness are associated with perceived nursing care quality. J Adv Nurs. 2017;73(1):217–27. 24. Valaitis R, Meagher-Stewart D, Martin-Misener R, Wong ST, MacDonald M, O’Mara L and The Strengthening Primary Health Care through Primary Care and Public Health Collaboration Team. Organizational factors influencing successful primary care and public health collaboration. BMC Health Serv Res. 2018;18(1):420. 26. Fatima T, Malik SA and Shabbir A. Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems. Int J Qual Reliab Manag. 2018;35(6):1195–214. 27. Ajayi AI. “I am alive; my baby is alive”: Understanding reasons for satisfaction and dissatisfaction with maternal health care services in the context of user fee removal policy in Nigeria. PLOS ONE. 2019;14(12):e0227010. 28. Haruna U, Dandeebo G and Galaa SZ. Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study. Adv Public Health. 2019;2019:e9181758. 29. Afaya A, Yakong VN, Afaya RA, Salia SM, Adatara P, Kuug AK and Nyande FK. A Qualitative Study on Women’s Experiences of Intrapartum Nursing Care at Tamale Teaching Hospital (TTH), Ghana. J Caring Sci. 2017;6(4):303–14. 30. Dzomeku MV. Maternal satisfaction with care during labour: a case study of the Mampong-Ashanti district hospital maternity unit in Ghana. Int J Nurs Midwifery. 2011;3(3):30–4. 31. Abidova A, da Silva PA and Moreira S. Predictors of Patient Satisfaction and the Perceived Quality of Healthcare in an Emergency Department in Portugal. West J Emerg Med. 2020;21(2):391–403. 32. Kiani FZ and Ahmadi A. Barriers and Facilitating Factors of Communication in Iranian Educational Health Care Centers: A Systematic Review. Strides Dev Med Educ [Internet]. 2019 Aug 18 [cited 2023 Sep 14];In Press(In Press). Available from: 33. Anderson RJ, Bloch S, Armstrong M, Stone PC and Low JT. Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence. Palliat Med. 2019 Sep 1;33(8):926–41. 34. Shahid S, Durey A, Bessarab D, Aoun SM and Thompson SC. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers. BMC Health Serv Res. 2013 Nov 4;13(1):460. 35. Beatson R, Molloy C, Perini N, Harrop C and Goldfeld S. Systematic review: An exploration of core componentry characterizing effective sustained nurse home visiting programs. J Adv Nurs. 2021;77(6):2581–94. 36. Goldfeld S, Price A and Kemp L. Designing, testing, and implementing a sustainable nurse home visiting program: right@home. Ann N Y Acad Sci. 2018;1419(1):141–59. 37. Kanda K, Blythe S, Grace R and Kemp L. Parent satisfaction with sustained home visiting care for mothers and children: an integrative review. BMC Health Serv Res. 2022;22(1):295. 38. Damashek A, Kothari C, Berman A, Chahin S, Lutzker JR, Guastaferro K, Whitaker DJ, Shanley J and SelfBrown S. Engagement in Home Visiting Services during the Transition from Pregnancy to Postpartum: A Prospective Mixed Methods Pilot Study. J Child Fam Stud. 2020;29(1):11–28. 39. Holland ML, Christensen JJ, Shone LP, Kearney MH and Kitzman HJ. Women’s Reasons for Attrition from a Nurse Home Visiting Program. J Obstet Gynecol Neonatal Nurs. 2014;43(1):61–70. 40. Nan Y, Zhang J, Nisar A, Huo L, Yang L, Yin J, Wang D, Rahman A, Gao Y and Li X. Professional support during the postpartum period: primiparous mothers’ views on professional services and their expectations, and barriers to utilizing professional help. BMC Pregnancy Childbirth. 2020;20(1):402. 41. Odetola TD and Fakorede EO. Assessment of Perinatal Care Satisfaction Amongst Mothers Attending Postnatal Care in Ibadan, Nigeria. Ann Glob Health. 84(1):36– 46. 44. Rodin D, Silow-Carroll S, Cross-Barnet C, Courtot B and Hill I. Strategies to Promote Postpartum Visit Attendance Among Medicaid Participants. J Womens Health. 2019;28(9):1246–53. 43. Hill Z, Okyere E, Wickenden M and Tawiah-Agyemang C. What can we learn about postnatal care in Ghana if we ask the right questions? A qualitative study. Glob Health Action. 2015;8(1):28515. 44. Xiao X, Ngai F wan, Zhu S ning and Loke AY. The experiences of early postpartum Shenzhen mothers and their need for home visit services: a qualitative exploratory study. BMC Pregnancy Childbirth. 2019 Dec 31;20(1):5. 45. Thapaliya R, Paudel K and Shrestha S. Satisfaction on Intranatal Services among Mothers in Pokhara, Nepal. J Health Allied Sci. 2021;11(1):65–71. 46. Wyles K and Miller YD. Does it get better with age? Women’s experience of communication in maternity care. Women and Birth. 2019 Jun 1;32(3):e366-75. 47. Panth A and Kafle P. Maternal Satisfaction on Delivery Service among Postnatal Mothers in a Government Hospital, Mid-Western Nepal. Obstet Gynecol Int. 2018;2018:e4530161. 48. Aasheim V, Waldenström U, Rasmussen S, Espehaug B and Schytt E. Satisfaction with life during pregnancy and early motherhood in first-time mothers of advanced age: a population-based longitudinal study. BMC Pregnancy Childbirth. 2014;14(1):86. 49. Ahmar EA and Tarraf S. Assessment of the SocioDemographic Factors Associated with the Satisfaction Related to the Childbirth Experience. Open J Obstet Gynecol [Internet]. 2014 Jul 15 [cited 2023 Sep 14];2014. Available from: PaperID=47828 50. Atiya KM. Maternal satisfaction regarding quality of nursing care during labor and delivery in Sulaimani teaching hospital. Int J Nurs Midwifery. 2016;8(3):18–27.


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