Client satisfaction with antenatal care services in public and private health facilities in Igbo Eze South local government area of Enugu State, Nigeria: a cross-sectional study

Antenatal care (ANC) is essential for reducing maternal and neonatal morbidity and mortality. In Nigeria, despite efforts to improve maternal health, satisfaction with ANC services remains suboptimal, particularly in rural and semi-urban areas. This study assessed client satisfaction with ANC services and associated factors in public and private health facilities in Igbo Eze South Local Government Area of Enugu State, Nigeria. A facility-based cross-sectional study was conducted from December 2023 to January 2024 among 246 pregnant women attending ANC. Participants were selected using multistage sampling from 11 health facilities. Data were collected using a structured interviewer-administered questionnaire adapted from the SERVQUAL model. Descriptive statistics summarized client characteristics and satisfaction levels. Chi-square tests were used to examine associations between socio-demographic variables and satisfaction, with significance set at p < 0.05. Participants had a mean age of 26.4 ± 6.1 years. The majority (80.1%) reported moderate satisfaction with ANC services, while 17.5% reported low satisfaction and only 2.4% were highly satisfied. Service quality was rated low by 78.9% of respondents. Accessibility was moderate in 58.9% of cases. Factors significantly associated with satisfaction were educational level ( p = 0.013) and parity ( p = 0.022). Clients expressed satisfaction with provider politeness and registration convenience, but dissatisfaction with waiting time, laboratory services, and health education was common. Despite generally moderate satisfaction with ANC services, perceived service quality remains poor. Gaps in infrastructure, provider communication, and accessibility persist, especially in rural settings. Interventions aimed at improving health facility conditions, provider training, and community engagement are essential to enhance client satisfaction and utilization of ANC services. Strengthening these areas is crucial for achieving national maternal health goals and Sustainable Development Goal 3.1.