Community Perception Regarding Maternity Service Provision in Public Health Institutions in 2018 and 2019: A Qualitative Study

Abstract

Background

In the perspective of health care, community perception is defined as a combination of experiences, expectations and perceived needs. The community and client’s perception of health services seem to have been largely ignored by health-care providers in developing countries. There is a knowledge gap about communities’ perception and perspective of maternal health. If the community’s perception is known, the quality of maternity care may be improved, maternal morbidity and mortality could be decreased, and the overall health of the mother can be improved. The aim of this study was to explore community’s perception of maternity service provision in public health institutions.

Methods

A qualitative study with the underpinning philosophy of phenomenology was conducted in five subcities of Mekelle city, Ethiopia. Focus group discussions (FGDs) and in-depth interviews (IDSs) with participants who are residing in Mekelle city and who experienced maternity service as a client or as attendants were conducted to collect the necessary information. Using a semi-structured tool that has been translated into the local language, collected data were analyzed thematically using computer-assisted qualitative data analysis software ATLAS version 7. Qualitative data were transcribed through replaying the tape recorded interview from IDIs and FGDs. The text was carefully read and similar ideas were organized together. The participant's inductive meanings were extracted verbatim and described in narratives. The researcher and research assistants independently transcribed participant's comments verbatim to confirm the reliability of the findings.

Results

Participants reported that maternal health services in public health institutions were negative. Participants described experiencing poor staff attitude, lack of prescribed drugs in the institutional pharmacies, long waiting time, family proximity by professionals, poor attention to women during labor, lack of privacy and mistreatment made them develop a negative perception towards public health institutions. Despite these complaints, participants acknowledged public health facilities for affordable, accessible, qualified personnel and usually stocked with quality medications and equipment.

Conclusion

This study revealed that the community has a negative perception of the maternal health services in the public health institutions. The main reasons for their negative perception were poor staff attitude, unavailability of prescribed drugs in the institutional pharmacies, long waiting time, family proximity by professionals, poor attention to women during labor, lack of privacy and mistreatment.

Keywords:

• perception
• maternity service
• attitude
• qualitative
• maternal health

Abbreviations

ANC, antenatal care; SGDs, sustainable development goals.

Data Sharing Statement

All the supportive material will be available when it is necessary.

Ethical Consideration

The study was conducted according to the Declaration of Helsinki. Information about the purpose of the study and procedures during the discussion and interview were explained to obtain informed consent from each participant. Before the actual data collection an ethical clearance letter was obtained from Mekelle University, College of Health Sciences, and Health Research Ethics Review Board (HERB), (reference no: ERC 1516/2018) and a support letter was obtained from the Tigray Regional Health Bureau. Informed oral consent or permission was obtained from the study participants. The objective of the study was explained to the study participants, privacy, and confidentiality was ensured. Furthermore, the study participant’s involvement in the study was voluntary.

Acknowledgments

The authors are grateful to Mekelle University and its project (MU-HU-NMBU) for financial and technical support. We also thank all participants who took part in the study. We are grateful to the Tigray Regional Health Bureau.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interests in this work.

Additional information

Funding

Mekelle University, MU-HU-NMBU project supported this study financially. These funding agents had no role in designing the study, data collection, analysis, and data interpretation, and writing the manuscript.