Cross-Cultural Validity and Reliability Testing of the Quality Prenatal Care Questionnaire in Iran

The quality of antenatal care is recognized as critical to the effectiveness of care in optimizing maternal and child health outcomes. Utilization indices exist to measure the quantity of prenatal care, but currently, there is no accessed instrument to assess the quality of prenatal care in Iran. The purpose of this study was to examine the cross-cultural adaptation of quality of prenatal care using the 46-item Quality Prenatal Care Questionnaire in low-risk pregnant women.

This cross-sectional and psychometric study was performed from June 2018 to January 2019. Two hundred thirty women were referred to community-based practitioners, antenatal hospital clinics, public system, and Private care options. The Quality Prenatal Care Questionnaire was used, and all the data were statistically analyzed using SPSS 22 and LISREL 8.80. The Chi-square test, Cronbachchr('39')s alpha coefficient, KMO index, and Bartlettchr('39')s test of sphericity, as well as EFA and CFA, were applied for statistical analysis.

Cronbachchr('39')s alpha for all items was 0.90, and ICC was 0.93. Explanatory factor analysis demonstrated the adequacy of the sampling (Kaiser-Meyer-Olkin=0.80) and significant factorable sphericity (p<0.001). CFA also confirmed the values of fit indices (RMSEA=0.07, CFI>0.92, x 2/df=2.25).

The Quality Prenatal Care Questionnaire is a valid and reliable instrument for measuring antenatal care quality. The Quality Prenatal Care Questionnaire will be useful in future research as an outcome measure to compare the quality of care across geographic regions, populations, and service delivery, models.