The quality of hospital-based maternity care in Turkey: findings regarding antenatal care

Janet M. Turan, Stanford University
Ayşen Bulut, Istanbul University
Hacer Nalbant, Istanbul University
Nuriye Ortayli, Istanbul University
Arzu Akalin, Istanbul University

This study aimed to gather comprehensive data from a few typical hospitals in order to gain in-depth understanding of problems with antenatal care in Turkey. The Bruce framework for quality of care was adapted for use in evaluating maternity services. Methods included examination of hospital records, in-depth interviews, exit questionnaires, and structured observations. Examination of the elements of quality of care using a variety of research methods to capture different perspectives was useful in understanding the problems. Although women had low expectations, they were more satisfied with care that included good interpersonal relations, information provision, and continuity. Providers felt constrained in providing quality care by heavy patient loads and lack of resources. On the other hand, observations of care revealed that many improvements in the quality of maternity care could be made with existing resources. Multi-faceted approaches are needed to address the complex problems with maternity care in this setting.