Scoping Review of Client Satisfaction with Institutional Childbirth Services and Intention for Future Utilization in Nigeria

Introduction: Maternal Mortality Ratio in several low and middle-income countries of the world, especially subSaharan Africa including Nigeria is high compared to that of high-income countries. Childbirth in well-equipped health facilities with skill birth attendants is believed to reduce maternal deaths. This scoping review is aimed at assessing satisfaction level with institutional Childbirth services, the associated factors and intention of women of child-bearing age in utilizing the health facilities for future deliveries. Methods: This was a systematic electronic literature search using major databases of peer reviewed journal articles on maternal satisfaction with institutional Childbirth. Based on the inclusion criteria specified for the study, data was extracted from high quality eligible studies, summarized, collated and analysed in thematic arears to produce a narrative account of the findings. Results: Twenty-five (25) studies were selected and included in the final analysis out of the 378 that were retrieved from the initial electronic search. Nineteen (19) were quantitative, 4 qualitative and 2 mixed studies. The studies covered the 6 geo-political regions of Nigeria. The studies were all assessed for maternal satisfaction based on the Donabedian analytic framework of structure, processes and outcome; in addition to access to care, sociodemographic and economic concerns. Twelve (48%) studies reported overall satisfaction of over 80%. Of the 18(72%) studies that reported on the health care environment, only 7(38.9%) suggested satisfaction and 11(61.1%) were dis-satisfied. Poor staffing was also a major concern. Only 6(24%) of the studies reported satisfaction with medicine and supply. Most complained of inadequacy and high cost of available drugs. Out of the 19 studies on interpersonal relationships, 10(52.6%) reported dis-satisfaction resulting from verbal, psychological and physical abuse by health workers. Conclusion: Although the overall reported satisfaction was fair, we recommend infrastructural upgrade, environmental cleanliness, training and retraining of staff to improve their interpersonal attitudes, provision of medicines and supply as well as equitable deployment of adequate number of staff to man the health facilities in the country.