Introduction
Research methods
Study period and setting
Study design and methods
Study population
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Women in the post-partum period who had delivered a baby at home or other health institution because their experience cannot be attributed quality of care at the study health centers
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Women who had childbirth in same health centre but is in the first 6 hours of delivery or is after 6 weeks of delivery, who are very sick or have a sick new-born to take part in this study.
Sample size and sampling technique
Groups | Sampling method | Sample size | Assumptions |
---|---|---|---|
Quantitative phase sampling and sample size | |||
Women in post-partum period | Sampling women survey: 10 women were interviewed from each of the 50 health centres. Systematic random sampling was used to select 10 women who were 6 hours to 6 weeks in the post-partum period. Women were selected from all eligible women who were in immediate post-partum care or who came to the health centre for post-natal care during the 2 -3 days visit to each of the health centres. | Sample size for women interview \({n}_1={n}_2=\frac{{\left({Z}_{a/2}\sqrt{2\overline{pq}}+{Z}_{\beta}\sqrt{p_1{q}_1+{p}_2{q}_2}\right)}^2}{\Delta ^2}\) Calculate \(\overline{p}=\frac{P_1+{P}_2}{2}\) = 0.25+ 0.15 = 0.2 2 ∆ = p1-p2 = 0.25 - 0.15 = 0.1 n1 = n2 = (1.96 √.2*.8 + 0.84 √0.25*0.75+ 0.15*0.85)2 (0.1)2 n1 = 250 n2 = 250 n = n1 + n2 = 500 A study in Addis Ababa reported client satisfaction of 20% on the intra-partum care [11] | P1 = % client satisfied of care at facilities with high quality score = 25% P2 = % client satisfied of care at facilities with low quality score = 15% 95% Confidence interval (Z∝/2 = 1.96) Power 80% (Zβ = 0.84) |
Qualitative phase sampling and sample size | |||
Midwife & Manager | Purposeful sampling was applied to select program managers and midwives | 20 midwives and 13 health centre managers were purposefully selected | Sample goes until saturation achieved |
Data collection instruments and operational definition
Data collection
Quantitative data analysis
Qualitative data analysis
Ethical considerations
Results
The profiles of the study respondents and participant
Socio Demograpic Variables | Frequency | Percent |
---|---|---|
Age | ||
15-19 year | 21 | 4.2 |
20-24 year | 164 | 32.8 |
25-29 year | 193 | 38.6 |
30-34 year | 77 | 15.4 |
>/=35 Year | 45 | 9.0 |
Marital Status | ||
Never married | 47 | 9.4 |
Married/living together | 447 | 89.4 |
Divorced/separated/Widowed | 6 | 1.2 |
Educational Status | ||
No Formal education | 44 | 8.8 |
Primary (grade 1-8) | 238 | 47.6 |
Secondary (grade 9-12) | 138 | 27.6 |
College education and above | 80 | 16.0 |
Employment status | ||
Employed in Govt, NGO or Private organization | 68 | 13.6 |
Self Employed | 76 | 15.2 |
Not Employed | 356 | 71.2 |
Family Monthly Income based on tax category | ||
≤ 1650 birr (≤33.00 USD) | 73 | 14.6 |
1651-3200 birr (33.01-64.00 USD) | 192 | 38.4 |
3201-5250 birr (64.01-105.00 USD) | 117 | 23.4 |
≥ 5251 birr (≥105.01 USD) | 91 | 18.2 |
Not Reported/disclosed | 27 | 5.4 |
Place of residence | ||
Within Addis Ababa City | 462 | 92.4 |
Outside of Addis Ababa city | 38 | 7.6 |
Number of children alive | ||
one | 218 | 43.6 |
Two | 167 | 33.4 |
Three | 77 | 15.4 |
Four or More | 38 | 7.6 |
Quantitative phase findings
Women experience of effective communication during childbirth
Effective communication | Frequency | Percent |
---|---|---|
The health care provider greeted woman at first encounter during child birth | ||
No | 162 | 32.4 |
Yes | 338 | 67.6 |
The health care staff introduce themselves to the woman at first encounter during child birth | ||
No | 412 | 82.4 |
Yes | 88 | 17.6 |
The health care providers communicated women about the care in a way you understand | ||
No | 146 | 29.2 |
Yes | 354 | 70.8 |
Women was given opportunity to ask questions or raise concerns | ||
No | 154 | 30.8 |
Yes | 346 | 69.2 |
Women receive enough explanation about the care | ||
No | 142 | 28.4 |
Yes | 358 | 71.6 |
Health care providers sought your consent before doing any procedure at all time | ||
No | 193 | 38.6 |
Yes | 307 | 61.4 |
Had effective communication with the obstetric care giver (score ≥ 4.5 out of 6) | ||
No | 270 | 54.0 |
Yes | 230 | 46.0 |
Women’s experience of emotional support during child birth
Supportive Care | Frequency | Percent |
---|---|---|
Encouraged to be in labor position of your choice | ||
No | 270 | 54.0 |
Yes | 230 | 46.0 |
Encouraged to mobilize during labor | ||
No | 213 | 43.6 |
Yes | 287 | 57.4 |
Encouraged to have enough fluid or fluid diet during childbirth | ||
No | 57 | 11.4 |
Yes | 443 | 88.6 |
Had her companion of choice during labour and delivery | ||
No | 388 | 77.6 |
Yes | 112 | 22.4 |
Companions were oriented of their role in supporting women during labour and delivery | ||
No | 421 | 84.2 |
Yes | 79 | 15.8 |
Provided pharmacologic pain relief during labour and delivery | ||
No | 406 | 81.2 |
Yes | 94 | 18.8 |
Had emotional support during labor and delivery (score ≥ 4.5 out of 6) | ||
No | 452 | 90.4 |
Yes | 48 | 9.6 |
Women’s experience of dignified care during childbirth
Degnified Care | Frequency | Percent |
---|---|---|
Childbirth area is clean | ||
No | 39 | 7.8 |
Yes | 461 | 92.2 |
Labor and delivery care you received ensure privacy | ||
No | 101 | 20.2 |
Yes | 399 | 79.8 |
Medical information and records kept confidential | ||
No | 215 | 43.0 |
Yes | 285 | 57.0 |
Women experience at least one form of verbal abuse | ||
No | 439 | 87.8 |
Yes | 61 | 12.2 |
Women experience at least one form of physical abuse | ||
No | 479 | 95.8 |
Yes | 21 | 4.2 |
Women reported that she was being ignored during labor and delivery | ||
No | 477 | 95.4 |
Yes | 23 | 4.6 |
Had dignified care (score ≥ 4.5 out of 6) | ||
No | 146 | 29.2 |
Yes | 354 | 70.8 |