Mothers' satisfaction with immediate postnatal care provided at Ndola Central Hospital, Zambia

Abstract

Introduction- Many mothers and their babies do not receive the recommended immediate postnatal care despite delivering from the hospital. At Ndola Central Hospital, there have been reports of mothers complaining of poor health care provision. Records also revealed high numbers of neonatal and maternal mortality. Between 2011 and 2013, a total of 265 and 47 cases of neonatal and maternal mortality respectively were recorded. Maternal and Neonatal morbidity and mortality are the traditional measures of the quality of care. To complement them, a patient centered measure such as measuring levels of mothers’ satisfaction with the care is required. The objective of this study was to determine the levels of mothers’ satisfaction with the immediate postnatal care provided at Ndola Central Hospital. It also aimed at establishing the association between mothers’ satisfaction with the immediate postnatal care with socio demographic and obstetric characteristics. Mothers' opinions regarding their satisfaction with care can provide an opportunity to plan and implement appropriate strategies that improve the quality of care. Methodology -A hospital based cross sectional study was conducted at Ndola Central Hospital between November and December, 2014. Two hundred and two mothers in the immediate postnatal period were selected by purposive sampling method. A structured interview schedule adapted from the Jipi’s Satisfaction with Postnatal Nursing Care Questionnaire was employed for data collection. The tool had six satisfaction subscales namely; information, communication, care and comfort, value and preferences, orientation and care specific to postnatal; on a five point Likert scale. It also had 11 socio demographic and obstetric characteristics. Mothers were interviewed one at a time. Stata version 10.0 running on windows 7 was used for data analysis. Spearman’s correlation coefficient (r) was used to investigate the association between variables. Linear regression modeling was also applied to test the significance of the association. Results- Overall, 26.2 percent of the mothers were fully satisfied with the immediate postnatal care provided, 35.6 percent were moderately satisfied, 27.2 percent were minimally satisfied, 9.9 percent were satisfied and 1 percent was dissatisfied with the immediate postnatal care provided. Of the six satisfaction subscales, information scored the lowest (63.4%) while communication scored the highest (85.9%). Of the 11 socio demographic and obstetric characteristics only the mothers’ employment status (p- value = 0.024) and the baby’s condition at birth (p-value = 0.037) had statistically significant association with the mother’ satisfaction with the immediate postnatal care. Conclusion- The study showed that the levels of satisfaction with the immediate postnatal care provided at Ndola Central Hospital were low among mothers as it would have been preferred that more mothers than 26.2% reported to be fully satisfied with the care provided. Individualized and satisfactory care was not provided as some mothers reported more satisfaction than others depending on their differences in characteristics. Periodic evaluation of the postnatal care must be done in order to improve the quality of care delivered, reduce neonatal and maternal morbidity and mortality and also satisfy the needs of the mothers and their babies. Key Words: Immediate Postnatal Care, Postnatal Mothers, Satisfaction