Perception of Person-Centred Maternity Care and Its Associated Factors Among Post-Partum Women: Evidence From a Cross-Sectional Study in Enugu State, Nigeria

Objectives Women are not getting adequate person-centred maternity care (PCMC) in low-income and middle-income countries despite being important in reducing maternal morbidity and mortality. This study validated a PCMC scale, and assessed perception of, PCMC and its associated factors among post-partum women in Enugu State, South-east Nigeria. Methods A cross sectional survey of conveniently selected childbearing women (n = 450), within 9 weeks post-partum, from 11 health facilities in two randomly selected health districts in Enugu State was conducted using an interviewer-administered, validated 30-item PCMC scale (scores 0-90). Data on women characteristics, facility characteristics and service type were also collected. Exploratory and confirmatory factor analyses, descriptive, bivariate and Generalized Linear Models analyses were conducted. Results Twenty-two items (scores 0-66) were retained in the PCMC scale with high internal reliability and goodness-of-fit indices. The mean scores (standard deviation) for total PCMC, dignity and respect, autonomy and communication, and supportive care were 49.07 (15.41), 9.95(3.20), 15.87(5.44), and 23.25(7.40) correspondingly. About 25% of women perceived PCMC as high. Marrying at age 20-29 years (β = 3.46, ρ = 0.017) and 30-49 years (β = -5.56, ρ = 0.020), self-employed women (β = -7.50, ρ = 0.005), married to a government worker (β = 7.12, ρ = 0.020), starting antenatal care in the third trimester (β = -6.78, ρ = 0.003), high participation in household decisions (β = -10.41, ρ <= 0.001), domestic violence experience (β = 3.60, ρ = 0.007), delivery at health centre (β = 18.10, ρ < 0.001), delivery at private/mission hospital (β = 4.01, ρ = 0.003), delivery by non-skilled attendant (β = -16.55, ρ <0.001); and delivery by community health worker (β = -10.30, ρ < 0.001) and experience of pregnancy complication (β = 4.37, ρ = 0.043) influenced PCMC. Conclusions The PCMC scale is valid and reliable in Nigeria. PCMC requires improvement in Enugu State. This study identified factors that may be considered for inclusion in intervention strategies.