Abstract
Background
Primary health-care centers provide outpatient health care and primary preventive activities for people in general and for mothers and children in particular. Medical care aims not only to improve health status, but also to respond to patients’ needs and wishes and to ensure their satisfaction with care. The patient-clinician relationship is a central feature of primary care.
Objective
The purpose of this study was firstly determining the utilization pattern of Maternal and Child Health (MCH) services in urban and rural health centers in El-Minia City and secondly identifying factors affecting client dissatisfaction with the services provided by the two centers.
Design
Cross-sectional study.
Method
The study is a cross-sectional descriptive study conducted among two MCH centers randomly selected in El Minia City (MCH); this study included 400 female clients, 200 from each center. An anonymous questionnaire was designed by the research team to assess the performance of the provided services as well as client satisfaction. The client satisfaction part of the questionnaire included five items: waiting time, environment, doctor-client interaction, nurse-client interaction, and economic feasibility. Assessment of client satisfaction was done using a scoring system rated by three levels of response categories: satisfied, accepted, and dissatisfied. Pareto charts were drawn according to the frequency of each category showing the level of 80% cumulative percentage as cutoff, which identifies the corresponding factors related to dissatisfaction.
Results
The study showed that the rural center had a higher frequency of attendance regarding the curative services, antenatal care (ANC), and delivery care, while the urban center had higher attendance for family planning services, despite higher utilization of the rural center; histories of abortion and under-5-year moralities were more prevalent among customers of the rural center than those of the urban center, and clients of the urban center reported more satisfaction than those of the rural one. The most common causes of dissatisfaction were long waiting time and improper environment. Nearly 15% of the deliveries of babies in the rural center were attended by non-skilled personnel, and about half of the clients of the family planning section used intrauterine devices as a method of contraception.
Conclusion
MCH centers provide many services for mothers and their children, and the majority of the clients were satisfied with the services. However, the most common reason for dissatisfaction was the long waiting time.
Recommendations include encouraging and rewarding any health facility that fulfills a high rate of attendance and client satisfaction, and reduction of waiting time. Attention should be directed to the environmental conditions of the rural center.
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Acknowledgement
The authors are grateful to the Medical Science Department, Institute of Environmental Studies and Research, Ain Shams University, and to the Public Health Department, College of Medicine, El Minia University. We thank all individuals who participated in the study and the members of both health centers (Eastern Health Unit and Nazlet Ebead Health Unit) in El Minia City.
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The authors disclose any relevant associations that might pose a conflict of interest.
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Awadalla, H.I., Kamel, E.G., Mahfouz, E.M. et al. Evaluation of maternal and child health services in El-Minia City, Egypt. J Public Health 17, 321–329 (2009). https://doi.org/10.1007/s10389-009-0255-8
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DOI: https://doi.org/10.1007/s10389-009-0255-8