ABSTRACT
Background: Understanding service quality dimensions regarding maternal and child health (MCH) care are important for their utilization, and it could help in planning interventions for their betterment. It also encourages adherence to the services and contributes to enhancing the quality of MCH care services provided in health-care facility. Objective: The objective of the study was to determine the services quality dimensions related to MCH care provided to beneficiaries. Materials and Methods: A cross-sectional, descriptive study conducted in Nagrik Hospital among women of reproductive age group (15–49 years) who had come at least once previously to avail the MCH services. Systematic random sampling and exit interview technique were followed and data collected using pre-designed, pre-tested semi-structured schedule and permission from Institutional Ethics Committee Maulana Azad University Jodhpur taken. To determine services quality dimensions related to MCH care, factor analysis was used. This statistical approach was utilized to construct new factors affecting the quality of MCH care services availed by the beneficiaries. The analysis was done using software Statistical Package for the Social Sciences for Windows version 18.0. Results: Among 226 study participants, 125 beneficiaries utilized maternal health care services and 101 availed child health-care services. Health-care provider’s characteristics, expectations of beneficiaries toward healthcare services attributes were found statistically significant toward perceived satisfaction for utilization pattern of MCH care services. Conclusion: Services quality dimensions related to MCH care provided to beneficiaries concluded as health-care provider’s characteristics, expectations of beneficiaries toward health-care services and support and help by supporting staff such as Yashoda, Class IV employees, and sweepers from this study.
ABSTRACT
Resumo Foz do Iguaçu participa do SIS-Fronteiras e instalou o Centro Materno Infantil (CMI), ofertando atendimento ao pré-natal das gestantes brasileiras moradoras no Paraguai (brasiguaias). Para analisar as características do CMI e comparar o perfil de brasiguaias com gestantes brasileiras residentes no Brasil, conciliou-se abordagem quanti-qualitativa na metodologia. Verificou-se que gestantes brasiguaias atendidas no CMI procuram o local devido à precariedade do sistema de saúde paraguaio. Elas são mais jovens, apresentam maior paridade, menor escolaridade e não têm companheiro, quando comparadas às moradoras no Brasil. Elas omitem onde moram, tentando minimizar a possiblidade de terem atendimento inferior ao das brasileiras do local, ou terem negado seu direito à consulta; e buscam o serviço de obstetrícia tardiamente para evitar a negativa do atendimento. Elas geram custo alto para o município, sobretudo pela desinformação sobre a sua história reprodutiva e gestacional, o que aumenta as chances de serem submetidas a parto cesáreo e de internação da mãe e/ou do bebê, por complicações. Ações efetivas em relação à saúde materno-infantil nas zonas de fronteira precisam ser priorizadas.
Abstract Foz do Iguaçu participates in the SIS-Fronteiras program and installed the Maternal and Child Care Center (CMI) to offer prenatal care service to pregnant Brazilian women resident in Paraguay (Brasiguaias). To analyze the characteristics of the CMI and compare the profile of Brasiguaias with pregnant Brazilian women resident in Brazil, a quantitative and qualitative approach in methodology was applied. It was found that Brasiguaias go to the CMI because of the precariousness of services of the Paraguayan Health System. They tend to be younger, bear more children, have lower education and are unmarried compared with pregnant Brazilian woman resident in Brazil. They omit where they live to avoid being denied the right or receiving inferior treatment than local pregnant Brazilian women and seek obstetric treatment later to avoid being denied attendance. Pregnant Brazilian women resident in Paraguay are onerous to the municipality, especially due to misinformation about their reproductive and pregnancy history, which increases the chances of undergoing cesarean delivery and hospitalization of the mother and/or infant due to complications. Effective actions in relation to maternal and child health in the border areas need to be prioritized.