Quality of care and its effects on utilisation of maternity services at health centre level.

ABSTRACT

OBJECTIVE: To determine antenatal attendance and place of delivery of women in Chilomoni health centre catchment area and how they perceived the quality of health care provided at the health centre. DESIGN: A cross-sectional household survey. SUBJECTS: Women aged between fifteen and forty nine years, who had delivered at least one child, and had stayed in Chilomoni health centre catchment area during the past five years. RESULTS: Of the 1108 women interviewed, 52% reported for antenatal care at the health centre, but only eight per cent used it for delivery. Reasons for not using the health centre were mainly family refusal and poor facilities at the health centre (68%). On the quality of care, 97% were satisfied with the providers' attitudes, 91% with communication, 86% with the providers technical competence in general, 97% with working hours, but only 37% were satisfied with privacy. Only four per cent were satisfied with the supply of drugs. Variables independently associated with non use of the health centre were lack of drugs (OR 2.8, p = 001), poor ambulance service (OR 2.4, p = 0.03), poor laboratory services (OR 1.7, p = 0.001), long waiting time (OR 1.6, p = 0.02) and lack of privacy (OR 1.5, p = 0.01). CONCLUSION: Few women use Chilomoni health centre for antenatal services and still fewer use it for delivery. Reasons for not using the health centre included refusal by the family members and the poor facilities at the health centre. We recommend that the facilities at Chilomoni health centre be improved immediately.