The organisational effects of antenatal services on mothers' satisfaction

Abstract

Perception discrepancies between care providers and consumers in the organisation of antenatal services may lead to the development and delivery of inappropriate services. This study looked at the organisation of different antenatal services in Malta. It explored the organisational effects of antenatal services on mothers' satisfaction to reveal areas for improvement. Two officers and six obstetricians completed a questionnaire that measured and compared the organisation at the obstetricians', hospital's and health centres' antenatal servtces. A convenient sample of 138 primigravid mothers from the obstetricians', general practitioners', hospital's and health centres' antenatal services, completed a second questionnaire that measured and compared their evaluations of these services. The organisation of these services differed especially the large number of carers and the short consultation time at the health centres. These health centres attained a significantly lower satisfaction rate, a lower attendance rate and poorer communication although no difference in intentions to re-use the service was shown. At these sites, carers and mothers had to spend time out of reduced consultation time 'to get to know each other'. Antenatal care is important to the mothers, one of the main reasons of which is to attain 'reassurance'. Mothers at the health centres were less likely to get 'reassurance' in terms of the short consultation time and the number of carers, and were less likely to be satisfied. Therefore, the more the number of carers and the less the consultation time, the poorer the communication and the less likely that satisfaction is achieved. Appointment systems used at the four distinct organisations gave rise to dissatisfaction from long waiting time. An evidence that the efficiency by which the services are provided should be improved.