Dimensions of patient satisfaction with comprehensive abortion care in Addis Ababa, Ethiopia

Background: Patient satisfaction is a measure of the extent to which a patient is content with the health care received from health care providers. It has been recognized as one of the most vital indicators of quality. Hence, it has been studied and measured extensively as part of service quality and as a standalone construct. In spite of this, there has been limited or no studies in Ethiopia that describe factors of abortion care contributed to women's satisfaction. This study aimed to identifying the underlying factors that contribute to patient satisfaction with comprehensive abortion care and at exploring relationships between total satisfaction scores and socio-demographic and care-related variables in Addis Ababa, Ethiopia.

Methods: At the beginning of the study in-depth interviews with 16 participants and a focus group discussion of 8 participants were conducted consecutively at the time of discharge to generate questions used to evaluate women's satisfaction with abortion care. Following generation of the perceived indicators, expert review, pilot study, and item analysis were performed in order to produce the reduced and better 26 items used to measure abortion care satisfaction. A total sample size of 450 participants from eight health facilities completed the survey. Principal component exploratory factor analysis and confirmatory factor analysis were conducted respectively to identify and confirm the factors of abortion care contributing to women's satisfaction. Mean satisfaction scores were compared across socio demographic and care-related variables such as age, educational level, gestational age (first trimester and second trimester), and facility type using analysis of variance.

Results: Exploratory factor analysis of the 26 items indicated that satisfaction with abortion care consisted of five main components accounting for 60.48% of the variance in total satisfaction scores. Factor loadings of all items were found to be greater than 0.4. These factors are named as follows: "art of care" which means interpersonal relationships with the care-provider, "physical environment" which means the perceived quality of physical surroundings in which care is delivered, including cleanliness of facilities and equipment, "information" which means the information received related to abortion procedures, "privacy and confidentiality", "quality of care" which refers to technical quality of the care provider. Furthermore, analysis of variance showed that overall satisfaction is found to be related to facility type, relationship status, gestational age, and procedural type.

Conclusion: The findings provided support that women's satisfaction with comprehensive abortion care has five major factors. Therefore, to improve the overall quality of comprehensive abortion care, attention should be given to the advancement of these components namely, positive interpersonal communication with care-receiver, pleasantness of physical environment, offering enough information related to the procedure, securing clients' privacy during counseling and treatment, and technical quality of the providers.