Development of a person-centered postnatal care scale: Validation in Ghana and Kenya

Patience A Afulani, University of California, San Francisco
Raymond Aborigo, Navrongo Health Research Centre
Hawa Malechi, Tamale Teaching Hospital
Anthony Akanlu, Navrongo Health Research Centre, Navrongo, Ghana
Moro Ali, Navrongo Health Research Centre, Navrongo, Ghana
Beryl Ogolla, Global Programs for Research and Training, Nairobi, Kenya
Odiase Osamuedeme, University of California San Francisco, San Francisco, CA, USA
Linnet Ongeri, Kenya Medical Research Institute, Nairobi, Kenya
Jaffer Okiring, Global Programs for Research and Training, Kampala, Uganda
Emma Sacks, John Hopkins University
Mercedes Bonet Semena, World Health Organization
Özge Tunçalp, World Health Organization

High quality postnatal care (PNC), including Person-centered postnatal care (PCPNC)--care that is respectful of and responsive to people’s preferences, needs, and values—is essential to achieving optimal pregnancy outcomes. While interest in person-centered care across the reproductive health continuum has increased, there are no validated tools to comprehensively measure PCPNC. Our aim is to develop and validate a tool to comprehensively measure PCPNC. We followed standard procedures for scale development. This included a literature review, expert reviews, and cognitive interviews to ensure content validity. Questions were iteratively revised at each stage and first administered in a survey to 300 postpartum women in Ghana and subsequently to 1000 postpartum women in Ghana and Kenya. The survey data was used for psychometric analysis, which yielded a 35-item PCPNC scale with three sub-scales for “dignity and respect,” “communication and autonomy,” and “responsive and supportive care, with high construct validity. Cronbach alpha for the full scale is 0.93, and that for the sub-scales >0.7 indicating internal consistency. The summative PCPNC score is correlated with perceived quality and satisfaction with PNC, suggesting good criterion validity. The PCPNC scale is thus a valid reliable scale that will facilitate efforts to measure and improve PCPNC.

Keywords: Sexual and Reproductive Health and Rights, Data and Methods, Health and Morbidity

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