Effect of involvement of midwives in maternal care on patient and provider satisfaction in secondary-level public health facilities in Bangladesh
A comparative quasi-experimental study
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Background: Maternity care satisfaction for pregnant women and recently delivered mothers is linked to both short- and long-term complications. For health care providers, dissatisfaction can lead to high turnover, reduced efficiency, and decreased service quality. Increased midwifery care coverage enhances satisfaction; however, the Government of Bangladesh-sanctioned midwife positions are limited to the primary health care level only, not extending to secondary or tertiary health tiers. We aimed to evaluate the impact of introducing midwifery care at secondary-level health care facilities in Bangladesh by comparing the satisfaction levels of both providers and patients with those receiving regular care. Methods: We conducted a quasi-experimental study from September 2021 to December 2023 at two secondary-level health facilities - Sunamganj District Hospital (DH) (intervention) and Khagrachari DH (control). The primary outcome was the mean (x̄) percentage score of maternal satisfaction with antenatal care (ANC), delivery, and postnatal care (PNC) services, along with providers' satisfaction regarding their working environment, training, logistical support, and overall patient and service satisfaction at both facilities. Results: We screened for eligibility a total of 200 pregnant women or recently delivered mothers who visited the facility for ANC, delivery, or PNC services. The satisfaction scores were significantly higher among women who received midwifery care compared to those who received regular care. The scores were for ANC x̄ = 97.8 (95% confidence interval (CI) = 96.6-99.0) vs. x̄ = 71.0 (95% CI = 68.7-73.4), for delivery x̄ = 97.9 (95% CI = 97.4-98.3) vs. x̄ = 83.3 (95% CI = 80.2-86.3), and for PNC x̄ = 97.5 (95% CI = 96.5-98.4) vs. x̄ = 77.7 (95% CI = 73.8-81.6). Similarly, the satisfaction score among midwives was significantly higher than among providers in regular care facilities (x̄ = 88.7; 95% CI = 82.9-94.5 vs. x̄ = 77.7; 95% CI = 73.0-82.3). Conclusions: Our study highlights that midwifery care significantly enhances patient and provider satisfaction compared to regular care across antenatal, delivery, and postnatal services
Environmental health · Family medicine · MEDLINE · Patient satisfaction · Political science · Public health · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Nursing · Patient Satisfaction in Healthcare
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