Empowering Maternity Care: Study Analyses Expectations and Perceptions

In relation to maternity services, evaluating the quality of care for mothers is crucial as emotional, cultural, and respectful assistance is essential during labor and delivery. Research focusing on how mothers perceive the quality of maternity services is not commonly conducted. Recent research paper aimed to assess the gap between mothers' expectations and perceptions of the quality of maternity services in a hospital setting in northwest Iran. The researchers used the SERVQUAL and HEALTHQUAL questionnaires to evaluate the service quality across various dimensions.

Study Population and Data Collection

The study was conducted in a teaching hospital in Tabriz, Iran that provides a range of women's health services, including prevention, diagnosis, treatment, and rehabilitation. The target population was pregnant women aged 15-45 who visited the hospital for delivery services and were hospitalized for at least 24 hours. A sample of 402 women was randomly selected, and 350 completed the questionnaires (response rate = 87.06%).

Measurement Tools and Data Collection

The SERVQUAL questionnaire measured service quality across five dimensions: tangibles, reliability, responsiveness, assurance, and empathy. The HEALTHQUAL questionnaire assessed four domains: environment, empathy, efficiency, and effectiveness. Participants completed the questionnaires twice - once on admission to assess expectations, and again before discharge to evaluate perceptions.

The results showed a significant negative gap between mothers' expectations and perceptions across all dimensions of both questionnaires. The largest gaps were found in the "assurance" dimension of the SERVQUAL scale (-0.69) and the "effectiveness" dimension of the HEALTHQUAL scale (-1.20). This indicates that the hospital's maternity services did not meet the women's expectations, particularly in areas related to staff competence, communication, and the ability to meet patients' emotional and psychological needs.

Factors Affecting Quality Gaps

Multivariate analysis identified several factors associated with wider quality gaps. Older patients, those with higher educational levels, higher incomes, and urban residents had larger negative gaps compared to younger, less educated, lower income, and rural participants. Additionally, first-time hospital visitors had greater quality gaps than those with prior experience.

Recommendations for Improving Service Quality

The researchers concluded that hospital managers need to develop strategies to improve staff interpersonal skills, communication, and the ability to build trust with patients. Addressing the psychological and emotional needs of mothers, in addition to the clinical aspects of care, is crucial to enhancing the overall quality of maternity services. Targeted interventions for high-risk groups, such as older, more educated, and higher-income women, may help reduce disparities in service quality.

Study Limitations and Recommendations

The study's limitations include its single-site design, reliance on self-reported data, and cross-sectional nature. The authors recommend conducting multi-site, longitudinal research incorporating both patient and provider perspectives to gain a more comprehensive understanding of maternity service quality.

Key Points

1. The study aimed to assess the gap between mothers' expectations and perceptions of the quality of maternity services in a hospital setting in northwest Iran, using the SERVQUAL and HEALTHQUAL questionnaires.

2. The study was conducted in a teaching hospital in Tabriz, Iran, with a sample of 402 pregnant women aged 15-45 who visited the hospital for delivery services and were hospitalized for at least 24 hours. 350 women completed the questionnaires.

3. The results showed a significant negative gap between mothers' expectations and perceptions across all dimensions of both the SERVQUAL and HEALTHQUAL questionnaires, with the largest gaps in the "assurance" dimension of the SERVQUAL scale and the "effectiveness" dimension of the HEALTHQUAL scale.

4. Multivariate analysis identified several factors associated with wider quality gaps, including older patients, those with higher educational levels, higher incomes, and urban residents, as well as first-time hospital visitors.

5. The researchers concluded that hospital managers need to develop strategies to improve staff interpersonal skills, communication, and the ability to build trust with patients, and address the psychological and emotional needs of mothers in addition to the clinical aspects of care.

6. The study's limitations include its single-site design, reliance on self-reported data, and cross-sectional nature, and the authors recommend conducting multi-site, longitudinal research incorporating both patient and provider perspectives.

Reference –

Parnian Rahimi et al. (2025). Gap Analysis Of Maternity Service Quality And Associated Factors At A Maternity Hospital In Northwest Iran: A Cross-Sectional Survey Using SERVQUAL And HEALTHQUAL Questionnaires. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07179-x.