Abstract

CABANAS DUARTE, Francisco; MOLINAS FERNANDEZ, Carlos E.; CABRAL DE BEJARANO, María Stella  and  MANCUELLO DE ALUM, Julia Noemí. ASSESSMENT OF THE QUALITY OF CARE IN MATERNAL HEALTH SERVICES AS PERCEIVED BY PATIENTS IN ASUNCIÓN AND CENTRAL DEPARTMENT, YEARS 2007 - 2008" . Rep. cient. FACEN [online]. 2010, vol.1, n.2, pp.31-53. ISSN 2222-145X.

According to patients, the quality of care in maternal health services is a difficult concept to measure or quantify. For this study, index of clinical governance linked to the quality of care in these institutions was used. This index is based on 40 variables such as, implementation of free services, availability of medicines and supplies, services offered, hours of operation, chart of pregnant women rights, human resources, waiting time, accessibility, coverage, availability and compliance of the Birth plan, etc. The aim of this study was to analyze the quality indicators and to assess the demand of attention on maternal health care institutions. Individual interviews were conducted with actual patients to be hospitalized or in consultation in two Sanitary Regions, Asunción and Central departments, during the period October 2007 to June 2008; a questionnaire consisting of open and closed questions was answered. Out of 255 completed interviews, it was found that 18,0% sought services at Specialized Hospitals (HE), 21.3% at District Hospitals (HD) and 16.4% at the Children and Maternal centre (CMI). Relating to the quality of care indicators, 40% considered them very good, 31% good, 17.6% fair, and 11.4% of poor quality. The HD CMI Fernando de la Mora, and the Health centre at Loma Pytá were considered to deliver poor quality services, while on the other hand, the Red Cross, the Regional hospital at San Lorenzo and San Pablo were considered to deliver very good quality of care. The significance tests show that, mothers who come to be admitted into hospital, on average come from longer distances in km, than mothers who come for consultation, (p<0.02), but the average time to reach the service from their home is not longer (p<0,08) and on average, spend more than mothers in consultation(p<0.001). With regard to the quality indicators, it was observed that these are neither related to the Sanitary Regions nor to the type of service (consultation/hospitalization), demonstrating that the quality of care in the Central department is independent of that provided in Asunción and that consultation is independent of hospitalization, (p<0.13)

Keywords : Quality of care; Availability of a Chart of Pregnant Women rights; Existence and enforcement of a Birth Plan; pocket money expenditure; Demand for care and Indicators of Clinical governance.

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