Rbf perceived quality

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Rbf perceived quality

  1. 1. Quality of Care – Client Perspectives Christabel Kambala
  2. 2. Experiential dimension of care Objectives • Reconstruct process of care • Assess the clients’ perception of quality of care
  3. 3. Methods • Cross-sectional facility-based survey among clients- baseline • Structured questionnaire with close-ended questions on: • Socio-demographic characteristics • Process of care-services received • Perceived quality of care • Convenience sampling: Women interviewed as they leave ANC, delivery, and PNC (exit interviews)
  4. 4. Perceived quality of Care measurement • Made of statements assessing quality of care components about how the women perceived the quality of care on that day. • The statements were read to the women and were to agree or disagree and rate their perceived quality of care, using a 10 point scale (10 as complete agreement and 1 as complete disagreement). • The higher the score the more highly quality was rated.
  5. 5. Dimensions of perceptions (Latent variables) Overall Perceived quality of Care Interpersonal Relationships She/he listened to me She/he behaved in a gentle manner Environment and conditions of the room I was set up comfortably. The room was clean & hygienic Health services in general The HW were well coordinated The quality of care was higher than I expected
  6. 6. Interviewer side
  7. 7. Interviewee side
  8. 8. Sample size ANC DELIVERY PNC BALAKA 77 36 61 DEDZA 102 65 75 MCHINJI 74 59 47 NTCHEU 135 44 49 TOTAL 388 204 232
  9. 9. Results: Characteristics of women (%) Variable ANC n=388 Delivery n=204 PNC n=232 Age <20 20-29 >30 23 53 24 20 58 22 21 57 22 Marital status non-married Married 2 98 7 93 6 94 Education None Primary Secondary & above 38 39 23 42 44 14 45 37 18 Literacy Illiterate Literate 34 66 34 66 39 61
  10. 10. Results: Characteristics of women (%) Variable ANC n=388 Delivery n= 204 PNC n=232 Gravid 1 2-3 >3 31 35 34 31 37 37 32 38 30 Number of children 1 child 2-3 children >3 children 35 20 45 4 36 60 3 64 33 History of miscarriage : no miscarriage miscarriage 86 14 89 11 79 21 History of still birth 96 4 97 3 94 6 no premature birth 94 premature birth 6 94 6 90 10 Premature birth no still birth still birth
  11. 11. Results: Experiences (%) Variable ANC, N=388 Delivery, N=204 PNC, N=232 Wait time above 1 hour 23 3 22 Not done Self introduction by HW 60 60 56 Explanation of exam procedures 27 40 24 Explanation of medication 22 30 37 Consent seeking 28 41 27 Encouraged to ask questions 37 61 47 Encouraged to have guardian 46 50 55 Confidentiality 6 4 8 Bp measurement 38 - 58 Bp measurement before del - 37 - Bp measurement after del - 57 - Baby weighed - - 23
  12. 12. Results: Perceived quality of ANC care • Interpersonal relationships: 10 items – mean rating =9 • Environment and conditions of the ANC examination room- 7 items- mean rating=9 • ANC health services in general-10 itemsmean rating=9 • Overall: mean=9
  13. 13. Factors significantly associated with perceived quality of ANC care. N=388 Variable Chi-square P-value Self introduction by HW (+) 6.071 0.0137 Explanation of exam procedures (+) 5.569 0.0183 Explanation of medication (+) 8.414 0.0037 Consent (+) 12.527 0.0004 Encouragement to ask questions (+) 11.872 0.0006 Confidentiality (+) 8.577 0.0034 Bp Measurement (+) 5.952 0.0147
  14. 14. Next Steps • Analysis PNC and delivery data • Bivariate • Regression model on determinants of perception
  15. 15. Thank you!

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