Toward the development of a short multi-country person-centered maternity care scale

Abstract

Objective: To develop a shortened, valid and reliable scale applicable across multiple settings for routine monitoring of person-centered maternity care (PCMC). Methods: Exploratory analysis was used to generate parsimonious versions of a 30-item PCMC scale in four datasets from cross-sectional surveys conducted between August 2016 and October 2017, involving women aged 15–49 years in Kenya, Ghana and India who had recently given birth. Analysis was informed by expert opinion via a separate online survey of global maternal and child health experts. Items retained in each dataset were compared, and those unique to a single setting removed. The remaining items were pooled and assessed for construct and criterion validity and reliability in each setting. Results: Thirteen items were retained for a potential multi-setting short PCMC scale, incorporating the domains of dignity and respect, communication and autonomy, and supportive care. Cronbach's alpha for the scale was >0.7 in each setting. Scores on the 13-item scale were correlated with the 30-item scale scores, and with global measures of care satisfaction in Kenya and India. Conclusion: Analysis yielded a 47% shorter PCMC scale, that showed promise for routine assessment of women's experience of care during childbirth across multiple settings. However, further validation is needed.