A Comprehensive Quality Measurement of Delivered Care for Pregnant Women in Tabriz, Iran

Quality in health care has three main dimensions: Technical Quality, Service Quality and Customer Quality. This study aimed to assess the quality of delivered maternity care based on Comprehensive Quality Measurement in Health care (CQMH) model. This cross-sectional study was conducted with the participation of 185 pregnant women in their ninth month of pregnancy who were receiving maternity care from urban health centers and health posts in Tabriz in 2011. All participants were selected randomly from 40 health centers and health posts. Data were collected using researcher-made questionnaire which its validity was reviewed and confirmed by 10 experts and its reliability was confirmed according to Cronbach's alpha index (Service Quality (SQ); α = 0.85, Technical Quality (TQ); α = 0.77, Customer Quality (CQ); α = 0. 71). Final scores for each dimension were referred on a 0-100 scale with high values indicating better quality. Independent Samples Test and ANOVA followed by Tukey HSD Post Hoc Test were conducted to compare CQ, SQ, TQ and QI score between categorical variables. Data were analyzed using SPSS-17 statistical package. The average Quality Index was 58.59 of a 0-100 scale and average SQ, TQ, CQ scores were 75.3, 40.54, and 67.79 respectively.The results regarding customer quality indicated that the majority of the mothers remained in active participation and taking action phase. There was a significant gap between received maternity care and recommended standards. The quality of inter-personal and non-technical aspects of prenatal care was poor. Quality Index indicates that the current situation was worrying about quality of care from the patients’ perspective. Empowering pregnant women by engaging them in the service delivery process and decision-making can promote customer quality and pregnant women’s ability to take good decisions and good action and improve other aspects of quality.