ArticlePloS one2019
"I am alive; my baby is alive": Understanding reasons for satisfaction and dissatisfaction with maternal health care services in the context of user fee removal policy in Nigeria.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Which Care-Seekers are Prioritized for Preventive Maternal and Child Health Services in a Low-Resource Setting? A Vignette Experiment in Rural Guinea-Bissau.Tropical medicine & international health : TM & IH · 2026Article
- Assessment of Maternal Satisfaction with Childbirth Services at Secondary Healthcare Facilities in District Dehradun, Uttarakhand, India-A Mixed Method Study.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2025Article
- Satisfaction of Mothers in the Puerperium Period With the Quality of Inpatient Stay: A Cross-Sectional Study in Mogadishu Public Hospitals.Nursing open · 2025Article
- Measurement, determinants and outcomes of maternal care satisfaction in Nigeria: a systematic review.BMJ public health · 2025Article
- Article
- Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review.BMJ open · 2023Article
- Unveiling contextual influences of maternal satisfaction with labour care services in Nigeria: A qualitative inquiry.African journal of primary health care & family medicine · 2023Article
- "I don't like to be seen by a male provider": health workers' strike, economic, and sociocultural reasons for home birth in settings with free maternal healthcare in Nigeria.International health · 2023Article
- To what extent is antenatal care in public health facilities associated with delivery in public health facilities? Findings from a cross-section of women who had facility deliveries in Nigeria.BMC public health · 2023Article
- Assessment of satisfaction with delivery care among mothers in selected health care facilities in Ekiti state.Journal of public health research · 2022Article
- Exploring underutilization of skilled maternal healthcare in rural Edo, Nigeria: A qualitative study.PloS one · 2022Article
- Access barriers to maternal healthcare services in selected hard-to-reach areas of Zambia: a mixed methods design.The Pan African medical journal · 2021Article
- Women's experiences of mistreatment during childbirth and their satisfaction with care: findings from a multicountry community-based study in four countries.BMJ global health · 2021Article
- Maternal health care services utilisation in the context of 'Abiye' (safe motherhood) programme in Ondo State, Nigeria.BMC public health · 2020Article
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Abstract
backgroundThe main policy thrust in many sub-Saharan Africa countries' aim at addressing maternal mortality is the elimination of the user fee for maternal healthcare services. While several studies have documented the effect of the user fee removal policy on the use of maternal health care services, the experiences of women seeking care in facilities offering free obstetrics services, their level of satisfaction and reasons for satisfaction or dissatisfaction are poorly understood.
methodsThis study adopted a mixed study design involving a population survey of 1227 women of reproductive age who gave birth in the last five years preceding the study (2011-2015), 68 in-depth interviews, and six focus group discussions. Simple descriptive statistics were performed on 407 women who benefitted from the user fee removal policy, while the qualitative data were analysed using thematic analysis.
resultsThe overall level of satisfaction with care received was remarkably high (97.1%), with birth outcomes being the central reason for their satisfaction. Participants were also satisfied with both the process aspect of care (which includes health workers' attitude and privacy) and the structural dimension of care (such as, the cleanliness of health care facilities and availability of and access to medicine). From the qualitative analysis, prolonged waiting-time, the limited scope of coverage, mistreatment, disrespect and abuse, inadequate infrastructure and bed space were the main reasons why a few women were dissatisfied with care under free maternal health care.
conclusionThe findings establish a high level of beneficiaries' satisfaction with care under free maternal health policy in Nigeria, raising the need for sustaining the policy in expanding access to maternal health services for the poor. Nevertheless, issues relating to prolonged waiting-time, the limited scope of coverage, mistreatment, disrespect and abuse, inadequate infrastructure and bed space require attention from policymakers.
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