# PATIENT SATISFACTION

# SATISFACTION WITH ANTENATAL CARE

Table 9 provides an overview of participants in the ANC exit interviews at baseline. The average age of respondents was just over 25 years, 79 percent of respondents were married at the time of the interview, and 65 percent were literate. The intervention arms were well balanced across all of these dimensions. There is, however, evidence of differences in education. In particular, women attending facilities in the additional financing arm were significantly more likely to have attended higher education than were women attending other facilities (p=0.07).

Women were asked a series of 12 questions related to their satisfaction with individual elements of their visits including, for example, their satisfaction with costs, wait times, and health worker communication. For each, a statement was read, and women were asked if they agreed, were neutral, or they disagreed. Binary variables were created by coding responses as “1” if a woman agreed, and “0” otherwise. Overall satisfaction scores were calculated by averaging over these 12 components. An overall score of “1” indicates that a woman agreed with all 12 questions, while a score of “0” indicates that she either disagreed or was neutral on all 12 questions.

The impact of the interventions on overall satisfaction is shown in Table 10. There is no indication that satisfaction changed over time in the control group <mark>(β = 0.006, p = 0.847).</mark> Relative to the pure control, the PBF group was associated with an 8.6 percentage point increase in satisfaction (p = 0.077). The results suggest a stronger effect in the full PBF than in the additional supervision group (10.5-percentage point increase) (Table 10, column 1).

Table 10 also shows the breakdown of the 12 individual components of satisfaction. Regression results indicate the percentage point increase or decrease in probability that a respondent in a given intervention group will agree with a statement, relative to the pure control, after adjusting for individual-level indicators (age, literacy, marital status, and education level) and facility-level indicators <mark>(type of health facility public/private/religious, urban/rural).</mark> For the first three dependent variables reporting whether women found the fees reasonable, while few of the results meet the 10 percent cutoff for statistical significance, women in the PBF group are consistently more likely to say that fees are reasonable than either the full control or partial treatment groups. The only statistically significant difference among these fee-related variables was that women in the PBF group were more likely to agree that medicine fees were reasonable than women in the additional financing and improved supervision groups (Table 10, column 4). There were no differences between groups in the likelihood that women agreed with the statement that health workers did not ask for additional presents or payments (Table 10, column 5).

Focusing on reported facility cleanliness, women in the PBF and the additional financing group both reported significantly higher levels of agreement than in the pure control group, although these scores were not significantly different from one another (Table 10, column 6). Although not meeting the 10 percent cut-off, this pattern was also seen in response to wait times, where the PBF group was associated with 16.1-percentage point increase over the pure control, compared to a decrease of 5.5-percentage points in the supervision only group. The pattern is slightly different in response to the question on privacy – while the additional supervision group continued to underperform relative to the pure control, the point estimate of the difference between the PBF 18