Clients’ satisfaction with malaria in pregnancy preventive services in Anambra State, Nigeria

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Abstract Background: Burden of Malaria in pregnancy (MIP) is still high despite deployment of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with malaria in pregnancy services delivered at antenatal clinics (ANC) in Anambra State Nigeria. Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of MIP preventive services, but 64.8% and 57.8% were not satisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of MIP preventive services. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare domain. Conclusion: A fair proportion of respondents were satisfied with the MIP services provided even though most were unsatisfied with the cost of assessing care and interpersonal relationship with health workers. To achieve satisfaction with services, the state government should subsidize the cost of services and encourage HWs to build good relationships with their clients especially at public secondary health facilities.

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