Malaria in pregnancy: Pregnant women’s satisfaction with quality of services in Public and Private Health Facilities in Ibadan

Abstract

Introduction: Effective treatment is a vital strategy in malaria control and management. This study assessed the satisfaction of pregnant
women to malaria in pregnancy (MIP) care and also compared the quality of MIP services in private and public healthcare facilities in Ibadan, Southwest Nigeria.

Methodology: This was a comparative cross-sectional study using mixed methods. A semi-structured interviewer-administered  questionnaire was used to obtain information on satisfaction with malaria in pregnancy services from 320 pregnant women selected by  simple random sampling from those attending antenatal clinics in private and public sectors. Also, with the aid  of an interview guide, key  informant interviews were conducted with purposively-selected healthcare providers to assess the  management of MIP. A checklist was  similarly used to assess the health facilities. Predictors of respondents’ satisfaction  were assessed using the Chi-Square test and binary  logistic regression. All analyses were performed at a statistical  significance level of α0.05.

Results :The pregnant women were aged 17 to 44 years with a mean age of 29.5±4.8 years. About two-thirds of the women were  graduates. Respondents’ mean gestational age, gravidity, and median parity was 6.6 ±1.8 months, 2.0±1.2, and 2.0 (range: 1.0 – 9.0), respectively. Most educated women preferred the private health facilities. However, about 62.5% of the women were not satisfied with the overall maternal care services in both the public and private health facilities. Respondents in the private health facilities (40.0%) were more satisfied than those in the public health facilities (35.0%). The overall respondents’ satisfaction with malaria care in pregnancy was poor. Multiple logistic regression revealed that theIndependent predictors of respondent’s overall satisfaction were level of facility (AOR=6.4, 95% CI=1.7, 24.0) and parity (AOR=2.7, 95% CI=1.40, 5.13). Qualitative findings show high awareness and familiarity as well as adherence to the malaria control policy among health workers in both private and public health sectors. Observational checklists revealed better facilities and services in private facilities compared to public health infrastructures.

Conclusion: The private healthcare facilities were rated as providing better services and satisfaction than the public facilities for malaria
care among pregnant women. Government needs to put in more effort in improving services in public healthcare facilities.