Clients and healthcare providers’ perspectives on Quality of maternal health services in primary healthcare facilities in Cross River State, Nigeria

Abstract

Context: Quality maternal health services are essential in reducing maternal mortality. For quality to be optimal, it is necessary to consider and satisfy the quality needs of both the providers and the consumers of healthcare. This study explored clients and healthcare providers’ perspectives on the quality of maternal health services provided in primary healthcare facilities in Cross River State, Nigeria.

Methods: A qualitative descriptive study was conducted involving 12 focus group discussions among women accessing immunization services in the State from October – December 2020 to explore women’s perception of the quality of care they receive, and 12 key informant interviews with healthcare providers to get their perspective of the quality of care they render to their clients. The interviews were audio-recorded following consent, transcribed and analysed manually using a framework thematic analysis approach involving four steps: familiarization, indexing/coding, charting, and mapping/interpretation.

Results: Both the women and the providers perceived quality of care as healthcare that meets the health demands of the clients through the provision of a holistic care, affordable, accessible and provided by competent staff with a positive attitude. The women identified poor state of the physical environment, inadequate commodities and supplies, poor funding, lack of basic equipment, long waiting times, inadequate staffing, poor attitude of healthcare providers as barriers to quality maternal health service, while healthcare providers perceived inadequate training/supervision and poor remuneration as an influence in their delivery of quality maternal health service.

Conclusion: In conclusion, quality maternal healthcare services was perceived by both women and providers as holistic, affordable, accessible, and delivered by competent, respectful staff. Nonetheless, systemic challenges like poor infrastructure, inadequate supplies, staffing shortages, long waiting times, and insufficient training, supervision, and remuneration continue to constrain the delivery of quality maternal health services. We therefore recommend that maternal healthcare quality be improved through strengthened infrastructure, sustainable funding and supplies, enhanced workforce capacity via training and fair remuneration, and the promotion of respectful, accessible, client-centered, holistic care.