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

Int J Gynaecol Obstet. 2019 Jul;146(1):80-87. doi: 10.1002/ijgo.12827. Epub 2019 May 9.


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.

Keywords: Ghana; India; Kenya; Maternity care; Measurement; Person-centered care; Respectful maternity care; Validation.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Delivery, Obstetric / psychology*
  • Female
  • Ghana
  • Humans
  • India
  • Kenya
  • Maternal Health Services / standards*
  • Middle Aged
  • Parturition / psychology*
  • Patient-Centered Care / standards*
  • Pregnancy
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Young Adult