Determinants of person-centered maternity care during child birth at the selected hospitals of South Gondar Zone, Northwest Ethiopia: mixed cross-sectional study

Abstract

Background: Person-centered maternity care (PCMC) is a key component of quality maternal care. It enhances women’s satisfaction and promotes institutional delivery. However, evidence from Ethiopia remains limited. This study assessed the level and determinants of PCMC among women giving birth in public hospitals in South Gondar Zone, Northwest Ethiopia. Methods: A mixed-method, cross-sectional study was conducted from November to December 2022 among 405 postpartum women selected through systematic random sampling. Quantitative data were collected using interviewer-administered questionnaires and analyzed with descriptive statistics and multiple linear regression. The PCMC scale was pretested at University of Gondar Comprehensive Specialized Hospital on 41 mothers (10% of the sample) and demonstrated strong internal consistency (Cronbach’s Alpha = 0.83 in this study). Qualitative data from in-depth interviews were pre-tested with 5 women and analyzed thematically. Integration of the two strands occurred during the analysis phase, with qualitative findings used to complement and contextualize quantitative results, thereby ensuring triangulation and a comprehensive understanding of person-centered maternity care. Results: The mean PCMC score was 58.62% of the total possible score. Subscale scores were: dignity and respect (77.35%), communication and autonomy (50.69%), and supportive care (55.88%). Longer hospital stay (two days: B = − 2.49, 95% CI: − 4.33, − 0.65; >2 days: B = − 2.43, 95% CI: − 4.64, − 0.21), being attended by only male (B = − 3.10, 95% CI: − 4.97, − 1.23) or only female providers (B = − 2.88, 95% CI: − 5.04, − 0.71), and complications affecting both mother and baby (B = 3.62, 95% CI: 0.59, 6.64) were significantly associated with person-centered maternity care. Descriptive statistics for quantitative data were summarized using means, standard deviations, percentages, frequency tables, and graphs. Unstandardized B coefficients (with 95% CIs reported in Results) were used to analyze effects and variability in PCMC. Both simple and multiple linear regression analyses were conducted, with statistical significance declared at p < 0.05 and 95% confidence intervals in the multivariable model. Conclusion: Person-centered maternity care in South Gondar Zone public hospitals was low, affected by provider sex, hospital stay, and complications. In qualitative studies, staff shortages, overcrowding, poor infrastructure, and cultural barriers emerged as major challenges. Improving PCMC requires better facility readiness, adequate staffing, and respectful, culturally sensitive care to ensure dignified childbirth experiences.