Exploring the experience of women using maternity services in Zimbabwe and Kenya

Sleeping baby

The aim is to develop a user-friendly phone based tool, which women can use to enter scores about their experiences with maternity services during delivery.

The information will be used to identify barriers to good quality care, develop standards of care and inform about how quality of care can be improved, to address acceptability of services.

The research consists of the following elements:

  • A systematic review of existing tools used to record women's experiences of maternity care in low resource settings.
  • Development of a simple, user-friendly tool to record women's experiences of maternity services in Kenya and Zimbabwe.
  • Piloting the tool, to evaulate women's experiences.

The prospective benefits are:

  • Helping healthcare providers to identify issues around acceptability, and to take measures to address them.
  • Highlighting gaps in the training of skilled birth attendants (SBAs), with the aim of improving thier communications skills and attitude towards women.
  • Enhance awareness among women of reproductive age that non-respectful care is not tolerated, and that they can expect acceptable care from SBAs.

The engagement of women through this platform has the potential for further health promotion. The improvement in care is expected to increase attendance of skilled deliveries among women. This will have a subsequent impact on maternal and infant mortality and morbidity, addressing Millenium Development Goals (MDG) 4 and 5.

Background to the study

While there are many qualitiative studies exploring experiences of maternity care in low-resource settings, the tools availabnle are often very long, administered by healthcare providers, in pilot format and not nationally agreed. They can only be applied by a trained assessor, to a limited number of women. This creates issues in terms of continuous monitoring, sustainability and transferability, which has been highlighted during monitoring and evaluation of the Making it Happen (MiH) programme in 11 countries.

The study will specifically look at whether a widely available, cost effective mobile phone application platform can be used to assess women's experience of maternity care. It will identify whether basic indicators of respectful care have been met.

The research is being run in Kenya and Zimbabwe, to complement the MiH programme currently running in both countries.

Kenya has an estimated maternal mortality ratio (MMR) of 360 per 100,000 live births. The stillbirth rate was estimated at 22 per 1,000 live births in 2009. 43% of births in Kenya are delivered in a health facility, while 57% of births take place at home.

Zimbabwe has 80% of births attended by skilled birth attendants, with MMR at 581 per 100,000 live births. While there has been progress reducing maternal mortality since it's peak in 2005, it is falling short of the 75% reduction required to meet MDG 5. Increasing the number of babies delviered in health facilities is an important factor in reducing the health risks for mothers and babies.