Assessment of the Provision of Quality Midwifery Care Service at Women’s and New Born Hospital, Lusaka Using a Modified Servqual Scale
DOI:
https://doi.org/10.47604/jhmn.3147Keywords:
Midwifery, Quality Care, SERVQUAL Scale, Service-QualityAbstract
Purpose: The aim of the study was to assess the quality of midwifery care service provided to women by midwives at Women and New-Born Hospital (WNBH) in Lusaka District of Zambia using a modified SERVQUAL scale questionnaire. The study intended to evaluate the quality of the service from the viewpoint of service providers and recipients of the service (Women).
Methodology: The research design was a non-experimental design utilisation a quantitative cross-sectional method. Systematic sampling was used to select 385 women and 185 midwives from the various health units. Quantitative data was analysed by employing descriptive statistics using the IBM Statistical Package for Social Sciences (SPSS) version 24. Chi-square and Fisher’s exact was conducted to test statistical significance between the independent and dependent variables.
Findings: Majority of women (321, 83.4%) mentioned that midwives provide poor quality of midwifery service while majority of midwives (183, 99.5) termed their quality service level as fair. The service quality gap between the perceived and expected quality service from the SERVQUAL questionnaire ranged from 0 to -15 for all the dimensions under study showing that standards were not reached.
Unique Contribution to Theory, Practice and Policy: Utilizing the SERVQUAL (service quality) theoretical model the research sought to identify service quality gaps which could enhance customer satisfaction if addressed. Recommendation includes a targeted effort by health facility to improve service quality through in-depth look at the tangibility, assurance, responsiveness, empathy and reliability dimensions of service quality. Quality should be a concern of every health care provider in the delivery system. Health institutions in Zambia, should make it as a mandate to understand client’s quality expectations in order to meet their quality needs leading to improved patient’s satisfaction, and ultimately increased facility utilization.
Downloads
References
Ahmed S.A.E., Mahimbo A., and Dawson A., (2022). Quality Intrapartum Care expectations and experiences of Women in sub-Saharan African Low and Low Middle-income Countries: A qualitative meta-analysis. Research Square. DOI: https:// doi.org /10. 21203/rs.3.rs-2019687/v1
Ali B.J., Gardi B., Othman B.J., Ahmed S.A., Ismael N.B., Hamza P.A., Aziz H.M., Sabir B.Y., Sorguli S., and Anwar G., (2021). Hotel Service Quality: The Impact of Service Quality on Customer Satisfaction in Hospitality. International journal of Engineering, Business and Management (IJEBM) ISSN: 2456-8678 [Vol-5, Issue-3, May-Jun, 2021] Issue DOI: https://dx.doi.org/ 10.22161 /ijebm.5.3
Ambo A.A., (2024). Assessing service quality in tertiary education using adapted SERVQUAL scale. Cogent Education. 10. 10.1080/2331186X.2023.2259733.
American customer satisfaction index (2022). Gold standard benchmarks for quality care: Healthcare. Retrieved October, 2024 from https://theacsi.org/
Amjeriya D., and Malviya R.K., (2012). Measurement of Service Quality in Healthcare Organization. International Journal of Engineering Research & Technology (IJERT). Vol. 1 Issue 8, October – 2012. ISSN: 2278-0181
Bogren M., Kaboru B.B., and Berg M., (2020). Barriers to delivering quality midwifery education programmes in the demographic republic of congo – An interview study with educators and clinical preceptors. Women and Birth. Volume 34, Issue 1. Pages e67-e75. ISSN 1871-5192, https://doi.org/10.1016/j.wombi.2020.06.004.
Carvajal B., Hancock A., Lewney K., Hagan k., and Jamieson S., (2023). A global overview of midwives’ working conditions: A rapid review of literature on positive practice environment. Women and Birth, Volume 37 (2024), 15-50. journal homepage: www.sciencedirect.com/journal/women-and-birth.
Cham L.B., and Johanson J., (2016). The Effect of Perceived Service Quality on Patients’ Behavioral Intentions – A Case Study in Provincial Hospitals in Ho Chi Minh City. University of Tampere. Vietnam.
Dansereau E., Masiye F., Gakidou E., Masters S.H., Burstein R., and Kumar S., (2015). Patient Satisfaction and Perceived Quality of Care: Evidence from a Cross-sectional National exit Survey of HIV and Non-HIV service users in Zambia. BMJ Open 2015;5: e009700. doi:10.1136/ bmjopen-2015- 009700
Filby A., McConville and Portella A., (2016). What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low- and Middle-Income Countries from the Provider Perspective. Retrieved October, 2024 from https://journals. plos.org/plosone/article?id =10.1371 /journal. pone.0153391
Gonzalez I.B., Melo N.A.P., Verastegui J.L., and Garcia G.M., (2016). Service quality and Users’ Satisfaction Assessment in the Health Context in Mexico. Journal of Management. 0120-4645 / E-ISSN: 2256-5078 /
Goshu M., Godefay H., Bihonegn F., Ayalew F., Haileselassie D., Kabede A., Temam G., and Gidey G., (2018). Assessing the competence of midwives to provide care during labor, childbirth and the immediate postpartum period – A cross sectional study in Tigray region, Ethiopia. PLoS One. 2018; 13(10): e0206414. Doi: 10.1371/journal.pone.0206414
GreeksforGreeks, (2024, October 12). SERVQUAL Model of Service Quality. Retrieved October, 2024 from https://www.geeksforgeeks.org/servqual-model-of-service-quality/
Grondahl V.A., Kirchhoff J.W., Andersen K.L., Sorby L.A., Andreassen H.M., Skaug E., Roos A.K., Tvete L.S., and Helgesen A.K., (2018). Health care quality from the patients’ perspective: a comparative study between an old and a new, high-tech hospital. Journal of multidisciplinary healthcare, 11, 591–600. https: //doi. Org /10.2147/JMDH.S176630
Hibusu, L., Sumankuuro, J., Gwelo, N.B. and Akintola O., (2018). Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia. BMC Pregnancy Childbirth 24, 20 (2024). https://doi.org/10.1186/s12884-023-06181-5
ISO 8402, (1994). Quality Management and Quality Assurance – Vocabulary. Retrieved October, 2024 from https://www.iso.org/standard/20115.html
Jonkisz A, Karniej P and Krasowska D. (2021). SERVQUAL Method as an "Old New" Tool for Improving the Quality of Medical Services: A Literature Review. Int J Environ Res Public Health. 2021 Oct 13;18(20):10758. doi: 10.3390/ijerph1 82010758. PMID: 34682499; PMCID: PMC8535625.
Kalunga A.C., and Kamanga T., (2016). Patients’ Satisfaction with Outpatient Pharmacy Services at the University Teaching Hospital and Ndola Central Hospital in Zambia. Journal of Preventive and Rehabilitative Medicine. Vol. 1, No.1, 2016, pp. 16-21. doi: 10.21617/jprm.2016.0101.3 ISSN: 2415-038X (Print)
Kazemi N., Ehsami P., Abdi F., and Bighami M.K., (2013). Measuring Hospital Service Quality and its Influence on patient Satisfaction: An Empirical Study using Structural Equation Modelling. Management Science Letters 3 (2013) 2125–2136
Khakbazan Z., Abbaszadeh Damghanian M., Abbaszadeh F., and Zareiyan A., (2020), Explaining the Concept and Dimensions of Midwifery Care Quality in Maternity Ward: A Qualitative Study. Journal of Complementary Medicine Research • January 2020 DOI: 10.5455/jcmr.2020.11.04.32
Khakbazan Z., Ebadi A., Geranmayeh M., and Momenimovahed Z., (2022). Factors in the Provsion of High-Quality Midwifery Care: A Qualitative Content Analysis. J Caring Sci, 2023, 12(1), 50-56 doi: 10.34172/jcs.2023.25576. Retrieved October, 2024 from https://jcs. tbzmed.ac.ir
Kriel, Y., Milford, C., Cordero, J.P. Suleman F., Steyn P.S., and Smit J.A., (2021). Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives. BMC Health Serv Res 21, 1246 (2021). https://doi.org/10.1186/s12913-021-07247-w
Lee, D., (2016). HEALTHQUAL: a multi-item scale for assessing healthcare service quality, Service Business, 2016; pp 1-26, doi:10.1007/s11628-016-0317-2
Loerbroks A., Weigl M., and Angerer P., (2016). Effort-reward imbalance and Perceived Quality of Patient Care: A cross sectional study among Physicians in Germany. BMC Public Health (2016) 16:342 DOI 10.1186/s12889-016-3016-y
Martinez-Fuentes C., (2018). Measuring Service Quality. Measuring hospital service quality: a methodological study", Managing Service Quality: An International Journal, Vol. 9 Issue: 4, pp.230-240, https://doi.org/ 10.1108/09604529910273049.
McFadden A., Marshall J.L., and Sharma B., (2020). Systematic Review of Barriers to, and Facilitators of, the provision of High-Quality Midwifery Services in India. Birth issues in Perinatal Care. WILEY. DOI: 10.1111/birt.12498. Birth published by Wiley Periodicals LLC. wileyonlinelibrary.com/journal/birth. 2020; 47:304–321.
Modiri M., and Mokoena B.A., (2020). The influence of service quality dimensions on customer satisfaction within VISA facilitation centers in South Africa. INTERNATIONAL JOURNAL OF Ebusiness And Egovernment STUDIES Vol: 12 No: 2 Year: 2020 ISSN: 2146-0744 (Online) (pp. 122-135) Doi: 10.34111/ijebeg.202012203
Nguyen, Q., Nisar, T.M., Knox, D. and Prabhakar, G.P. (2018), "Understanding customer satisfaction in the UK quick service restaurant industry: The influence of the tangible attributes of perceived service quality", British Food Journal, Vol. 120 No. 6, pp. 1207-1222. https://doi.org/10.1108/BFJ-08-2017-0449
Ntalasha, H., Simona, S., Moyo, F., Miti, J., Kabembo, I., Machacha, E., Libati, M., Ng’andu, E. and Mubita, A. (2018) An Assessment of Quality Assurance in HIV and AIDS-Related Services in Chivuna Rural Health Facility of Southern Zambia. World Journal of AIDS, 8, 37-52. doi: 10.4236/wja.2018.81004.
Nyambundi H., Aliata V., and Odondo A., (2021). Effect of Tangibility on Customer Satisfaction among Micro Finance Banks Customers in Kenya. Retrieved October, 2024 from https://www.researchgate.net/publication/356173616
Parasuraman A.P., Berry L.L., and Zeithaml V.A., (1985). A Conceptual Model of Service Quality and its Implication for Future Research (SERVQUAL). The Journal of Marketing. 49. 41-50. 10.2307/1251430.
Parasuraman A.P., Berry L.L., and Zeithaml V.A., (1991). Refinement and Reassessment of the SERVQUAL scale. The Journal of Retailing. 67. No.4, 1991, pp 57-67.
Ramya N., Kowsalya A., and Dharanipriya K., (2019). Service Quality and its Dimensions. EPRA International Journal of Research and Development (IJRD) |ISSN:2455-7838 (Online) Volume: 4, Issue:2, February 2019
Ruotsalainen S., Elovainio M., Jantunen S., and Sunervo T., (2020). The mediating effect of psychosocial factors in the relationship between self-organizing teams and employee wellbeing: A cross sectional observational study. Retrieved October, 2024 from https:// www.sciencedirect.com/science/article/pii/S0020748922002449
Sandall J., (2023). The Contribution of Continuity of Midwifery Care to High Quality Maternity Care. The royal College of Midwives. UK. Retrieved from www.rem.org.uk
Shafii, Milad & Rafiei, Sima & Abooee, Fatemeh & Bahrami, Mohammad & Nouhi, Mojtaba & Lotfi, Farhad & Khanjankhani, Khatere. (2016). Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision-Making Techniques. Osong Public Health and Research Perspectives. Doi: 7. 10.1016/j.phrp. 2016.05.001.
Shukla, A., Mishra, A. & Dwivedi, Y. (2023) Expectation Confirmation Theory: A review. In S. Papagiannidis (Ed), TheoryHub Book. Retrieved from https://open.ncl.ac.uk / ISBN: 9781739604400
Teston N., (2019). An effective approach to defining product quality: the 7 dimensions of J. L. Adams. Retrieved July, 2024 from https://www.linkedin.com/pulse/effective-approach-defining-product-quality-7-j-l-adams-teston/
Turner L., Ball J., Meredith P., Kitson-Reynolds E., and Griffiths P., (2024). The association between midwifery staffing and reported harmful incidents: a cross sectional analysis of routinely collected data. Retrieved July, 2024 from https://www. ncbi.nlm. nih. gov/pmc/ articles PMC10976845/
Vencataya L., Pudaruth S., Juwaheer R.T.D., and Dirpal G., (2019). Assessing the Impact of Service Quality Dimensions on Customer Satisfaction in Commercial Banks of Mauritius. Studies in Business and Economics no. 14(1)/2019. DOI 10.2478/sbe-2019-0020 BE no. 14(1) 2019
Webb S., (2024, July 5). 5 reasons why quality improvement is important in healthcare. https://www.verita.net/blogs/why-quality-improvement-is-important-in-healthcare/#: ~:text=It%20is% 20crucial%20to% 20understand, in% 20healthcare%20benefits% 20 everyone%20involved.
WHO, (2024, March 11), Quality of Care https://www.who.int/health-topics/quality-of-care# tab=tab_1
WHO, Maternal Health Unit, (2018, October 10), Midwifery Education and Care? https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/ maternal health/midwifery#:~:text=Beyond%20preventing%20maternal% 20 and % 20newborn,childhood%20development%20and%20postpartum%20depression
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Namayipo Wamukankamba Stella Nankamba, Prof. Erastus Mwanaumo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.