Application of donabedian quality-of-care framework to assess the outcomes of preconception care in Urban health centers, Mashhad, Iran in 2012

ABSTRACT

Health of mothers and children is one of the most critical public health issues around the world, and women's awareness of these problems will enable them to avoid unintended consequences. It is futile to plan for improving health care services without considering the patients' opinions. According to World Health Organization [WHO], Donabedian model is an appropriate framework for health care assessment, and pays particular attention to raising client's awareness, and satisfaction of the outcomes. This study was carried out in order to determine the quality of preconception care in health centers of Mashhad, in 2012. This descriptive study was conducted on women in their reproductive age, who received preconception care in health centers of Mashhad. The demographic and obstetric data were collected by questionnaires of preconception care, which were designed based on the outcome aspect of Donabedian model. This model consisted of a questionnaire related to the knowledge of preconception care, and one on patient's satisfaction. Data were analyzed by SPSS version 16 using statistical tests of ANOVA, Chi-square and Pearson correlation coefficient. The mean age of the participants was 26.93 +/- 5.22, and average of 6.32 +/- 4.77 years had passed since their marriage; also 67.4% had experienced 1-6 pregnancies. The mean score of patient's satisfaction was 75.56 +/- 11.84, and that of preconception care knowledge was 14.8 +/- 4.53. According to the results, it is recommended that more attention be paid to preconception health care in continuous medical education programs [CME]. Moreover, better instructions should be provided for the clients to raise their awareness in this area