title: Women's satisfaction with delivery care in Nairobi's informal settlements.
abstract: OBJECTIVE
  To quantify women's satisfaction with delivery care in informal settlements of Nairobi, Kenya, and to determine characteristics of women and delivery care associated with satisfaction.
  
  
  METHODS
  Household survey data analysis of 1266 women who delivered in health facilities in 2004 or 2005.
  
  
  METHODS
  Two densely populated informal settlements 7 and 12 km from Nairobi's center, where residents work primarily in the nearby industrial area or in the informal sector. Outcome Satisfaction was assessed by whether women would recommend the delivery care facility and deliver there again.
  
  
  RESULTS
  Over half (56%) of women would both recommend and deliver again in the same facility. In multivariate analysis, women's satisfaction with delivery care was associated with greater provider empathy (OR = 3.68, 95% CI 2.27, 5.97). Women's satisfaction with delivery care was also associated with the pregnancy having been wanted (OR = 2.75, 95% CI 1.82, 4.14) or mistimed vs. unwanted. Women delivering at private facilities in the settlement near the industrial area were more satisfied than women delivering at private facilities in the more distant and marginalized settlement (OR = 2.12, 95% CI 1.45, 3.09). The association of women's satisfaction and provider empathy was stronger among women who experienced complications compared to those who did not.
  
  
  CONCLUSIONS
  Health providers should be sensitized to the finding that unintended pregnancy is associated with lower satisfaction with delivery care. Maternal health programmes should focus on increasing provider empathy, especially for women who experience complications, in both private and government health facilities.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street,Baltimore, MD 21205, USA. ebazant@jhsph.edu
authors.forename: Eva S
authors.initials: ES
authors.lastname: Bazant
authors.forename: Michael A
authors.initials: MA
authors.lastname: Koenig
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007630:Kenya; D008427:Maternal Health Services / Q000592:standards*; D016017:Odds Ratio; D017060:Patient Satisfaction; D055815:Young Adult