Abstract
Background
The provision of midwife-led continuity of care (MLCC) is effective in high-resource
settings in improving maternal satisfaction. This study aimed to evaluate the effect
of MLCC on women’s satisfaction with care in a low-income/resource setting.
Method
A study with a quasi-experimental design was conducted from August 2019 to September
2020 in four primary hospitals in the north Shoa zone, Amhara regional state, Ethiopia.
A total of 1178 low-risk women were allocated to one of two groups; the MLCC (intervention
group) that received all antenatal, intrapartum, and immediate postnatal care from
a primary midwife or backup midwife) (n = 589) and the shared model of care (SMC)
group that received care following established practice in Ethiopia, care from different
staff members at different times) (n = 589). Data for this paper were collected using
face-to-face interviews at the women’s home at the end of the postpartum period. The
study’s outcome was the mean sum-score of satisfaction with care through the antenatal,
intrapartum, and postnatal period continuum, where mean sum-scores range from 1 (lowest)
to 5 (highest).
Findings
Compared with SMC, MLCC was associated with statistically significantly higher satisfaction
with all continuity of care (4.07 vs. 2.79 adjusted mean difference 1.27, 95% CI 1.18–1.35;
p < 0.001), during antenatal care (4.14 vs. 2.81 adjusted mean difference 1.33 (95%
CI 1.22–1.52), intrapartum care (3.83 vs. 2.71 adjusted mean difference 1.06 (95%
CI 0.88–1.23) and postnatal care (5.46 vs. 3.71 adjusted mean difference 1.75 (95%
CI 1.54–1.94)).
Conclusion
MLCC increased women's satisfaction with maternity care for women at low risk of medical
complications. These findings confirm that the MLCC model will be applicable in the
Ethiopian health care system with similar settings.
Keywords
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Article info
Publication history
Published online: January 20, 2022
Accepted:
January 12,
2022
Received in revised form:
January 12,
2022
Received:
September 17,
2021
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
