Perceived quality of care during delivery and its influences on choosing place of birth in Sengerema District, Mwanza Tanzania

Background: Unnecessarily high maternal mortality ratio remains a challenge in many developing countries. This is exemplified by Tanzania in which the maternal mortality ratio is 410. Health Facility delivery can help save lives of millions of women. Provision of quality care during delivery is essential in attracting women to use these services. The aim of this study was to determine the perceived quality of care and its influence on place of delivery among women who have delivered in the past one year in Sengerema district, Mwanza region. Methods: The study employed community based Cross section design and included both qualitative and quantitative approaches. A total of 582 women who delivered in the past one year were recruited by multistage sampling technique and interviewed using interviewer-administered questionnaires. Using SPSS version 17, analysis was performed to determine the effects of quality of care during delivery on intention for future use or recommending to others. Qualitative study design was employed to expand on obtaining knowledge on experiences of women during delivery. A total of 26 individuals were interviewed including health workers and women who have delivered in the past one year. The information obtained was coded and categorized for content analysis. The ethical approval was obtained from MUHAS Research Ethics Committee and permission to conduct study was given by Sengerema district authority. Results: Among the women interviewed 61%, 48%, and 22% agreed that health care workers offered respect and support, shared information and were available during delivery respectively. However, quality of interpersonal care in terms of Information Shared, Support and Respect, and Availability of HCW during delivery had no bearing on women’s choice of future delivery. Previous use of health facility for delivery is a strong predictor for women to use/recommend to other women to use health facility for future delivery. Women who have used health facility for delivery are six times more likely to use again or recommend to others the use of health facilities for delivery with the true population value being between 3 and 14 women. Conclusion and Recommendation: Even though women expect to receive good quality of interpersonal relationship from health care workers during delivery, it has no influence over future choice of delivery place. The perceived quality of care did not meet the Tanzania’s Standards-Based Management and Recognition for care during delivery in health facilities. It is thus recommended strategies be set to improve on the quality of care during delivery. Also further studies to assess the reason for health care workers in terms of offering good quality of care underperformance is essential