Factors influencing satisfaction of the quality of antenatal care services in health facilities in Lusaka district: a cross-sectional study


  • Melody Mudenda Mwanja School of Postgraduate Studies, University of Lusaka, Zambia
  • Eustarckio Kazonga School of Medicine and Health Sciences, University of Lusaka, Zambia




Antenatal care, Expectant mothers, Quality of ANC, Service satisfaction, SERVQUAL model


Background: Patient satisfaction in antenatal care (ANC) service delivery comes from good patient outcomes and the good quality of care that a patient receives. The objective of this study was to determine factors influencing the quality of ANC services in health facilities in Lusaka District in Zambia.

Methods: A quantitative approach with a cross-sectional study design was used. The sample size was drawn from 20 public and private. From these institutions, a random sample of 385 participants (expectant mothers) was selected. Furthermore, 40 care-givers were selected as key informants. The questionnaires and interviews were employed to collect data. The data was analysed by performing factor analysis, correlation analysis and multiple regression analysis using statistical package for social sciences (SPSS) 16.0.

Results: There was a strong positive correlation between the variables: quality of ANC service and patient satisfaction, the relationship was not very strong as most of the dimensions of ANC were influencing satisfaction slightly above 60%. The empathy dimension was regarded to be the major predictor as it was rated highly in influencing for satisfaction with a Cronbach’s alpha score of above 0.8. However, the cost of service showed a strong negative correlation in relation to satisfaction.

Conclusions: The study concludes that ANC services provision has an influence on the expectant mothers’ satisfaction. Different dimensions of antenatal care services influence satisfaction differently and a combination of several dimensions posts increased satisfaction.

Author Biography

Melody Mudenda Mwanja, School of Postgraduate Studies, University of Lusaka, Zambia

Department of Postgraduate studies


Oladapo O, Osiberu M. Do socio-demographic characteristics of pregnant women determine their perception of antenatal care quality? Matern Child Health J. 2008;3(4):505-11.

Fannya P, Putra DH, Dewi DR. The relationship of patient satisfaction level with word of mouth on health services: systematic review. Int J Community Med Public Health. 2022;9(8):3293-6.

Ministry of Health, Zambia. Introduction to Focused Antenatal Care. Lusaka: Maternal and Neonatal Health. 2016.

Katemba BM, Bwembya P, Hamoonga TE, Chola M, Jacobs C. Demand side factors associated with quality antenatal care services: a case study of Lusaka District, Zambia. Front Public Health. 2018;6:285.

Fagbamigbe AF, Idemudia ES. Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey. Reprod Health. 2015;12:88.

Ali F, Rasoolimanesh SM, Sarstedt M, Ringle CM, Ryu K. An assessment of the use of partial least squares structural equation modeling (PLS-SEM) in hospitality research. Int J Contemp Hosp Manage. 2018;30(1):514-538.

Khan FT. Comparative study of service performance in Saudi hospitals: the government versus the private health care system. Int J Econom Commerce Manage U K. 2018;5:83-92.

Admasu B, Temamen T, Dagmawit B, Abdela A. Job satisfaction and associated factors among nurses working in the operation theater at government hospitals of Eastern Ethiopia, 2017. Palliat Med Care. 2018;5(2):1-7.

Boller C, Wyss K, Mtasiwa D, Tanner M. Quality and comparison of antenatal care in public and private providers in the United Republic of Tanzania. Bull World Health Organ. 2003;81(2):116-22.

Nicholas J, Fogarty AS, Boydell K, Christensen H. The reviews are in: a qualitative content analysis of consumer perspectives on apps for bipolar disorder. J Med Internet Res. 2017;19(4):e7273.

Kotler P, Keller K. Marketing Management. 12th edn. Prentice Hall, Upper Saddle River; 2006.

Saunders M, Lewis P, Thornhill A. Research methods for business students. Pearson education; 2009.

Parasuraman A, Berry LL, Zeithaml VA. Understanding customer expectations of service. Sloan Manage Rev. 1991;32(3):39-48.

Zambia Statistics Agency Living Conditions Monitoring Survey (LCMS). Lusaka, Zambia; 2020.

Central Statistical Office. Zambia Demographic and Health Survey, Central Statistical Office, Lusaka; 2017.

Kothari CR. Research Methodology: Methods and Techniques. New Age International; 2004.

Ware JE, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983;6(3-4):247-63.

World Health Organisation (WHO). Standards for improving quality of maternal and newborn care in health facilities. Geneva, Switzerland: WHO; 2016.

Marquis BL, Huston CJ. Leadership roles and management functions in nursing: Theory and application. 5th edn. Lippincott Williams and Wilkins; 2009.

Parasuraman A, Zeithaml VA, Berry L. SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. J Retail. 1988;64(1):12-40.

Osamor PE, Grady C. Autonomy and couples’ joint decision-making in healthcare. BMC Med Ethics. 2018;19:3.

Ministry of Health, Zambia, 2019. Reproductive, Maternal, New-born, Child and Adolescent Health and Nutrition Communication and Advocacy Strategy 2018-2021, Lusaka, Zambia. Available from: https://www.moh.gov.zm/?wpfb_dl=111. Accessed on 4 April 2022.

Babalola, S. Women’s education level, antenatal visits and the quality of skilled antenatal care: a study of three African countries. J Health Care Poor Underserved. 2014;25(1):161-79.

Furuta M, Salway S. Women’s position within the household as a determinant of maternal health care use in Nepal. Int Fam Plan Perspect. 2006;32(1):17-27.

Chemir F, Alemseged F, Workneh D. Satisfaction with focused antenatal care service and associated factors among pregnant women attending focused antenatal care at health centers in Jimma town, Jimma zone, South West Ethiopia; a facility based cross-sectional study triangulated with qualitative study. BMC Res Notes. 2014;7:164.

Wachata SM, Lingenda G, Kazonga E. Analysis of (ANC) determinants of late first antenatal care booking in Kasenengwa District, Eastern Province, Zambia: a cross-sectional study. J Gynecol Obstet. 2021;9(5):178-88.

Erci B, Ivanov L. The relationship between women’s satisfaction with prenatal care service and the characteristics of the pregnant women and the service. Eur J Contracept Reprod Health Care. 2004;9(1):16-28.




How to Cite

Mwanja, M. M., & Kazonga, E. (2022). Factors influencing satisfaction of the quality of antenatal care services in health facilities in Lusaka district: a cross-sectional study. International Journal Of Community Medicine And Public Health, 10(1), 70–77. https://doi.org/10.18203/2394-6040.ijcmph20223528



Original Research Articles