Pregnant Women Expectations and Perception of Antenatal Care Services at Primary Health Centres in Port Harcourt
The notion of quality is meaningful when the stated or implied needs of the patients who are the consumers of health services are met. Estimation of the "quality gap" between patients' expectation before encounter and perception after encounter with health service along quality dimensions are relevant in current quality improvement practice. This study examined the expectations, perceptions, and gap in service quality from the perspective of pregnant women attending ANC at PHCs in Rivers State.
Descriptive, cross-sectional study carried out at Primary Healthcare Centres (PHCs) in Rumuigbo and Ozuoba, in Port Harcourt. Outcome variables were clients' expectation, perceptions, and possible gaps on 22 aspects under 5 service quality dimensions of ANC at the PHCs. Data was collected over a period of six months from 319 clients using the validated SERVQUAL instrument with 5-point Likert type scale.
Response rate was 94.7% and on the average, respondents' expectation score (Mean = 4.30, S.E. = 0.029) was more than their perception score for quality (Mean = 3.56, S.E. = 0.042). This gap score of 0.74,95%CI [0.66,0.82] was statistically significant t(317) = 17.2, p <0.001. Clients' expectation had a medium-sized effect on their perceptions r = 0.31, 95CI [0.19, 0.41], p < 0.001. We reported statistically significant gaps in all five dimensions and majority of the criteria for service quality. Predictors of unmet expectations were younger age (p = 0.001), number of previous visits (p=0.006), primary education (p=0.006) and non-working women (p=0.001). Polite disposition of healthcare staff had highest effect on clients' perception while non-availability of modern healthcare equipment at the health centres was of utmost concern to them.
Study provided an estimate of the unmet expectations of pregnant women for antenatal care services. The findings have important clinical and policy implications and we recommend further analysis of root causes of these gaps and the design of appropriate interventions that would lead to the re-organisation of services around clients' needs and expectations.
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