Notre Dame researchers’ article on maternity care in peri-urban settings published in PLOS ONE

An article co-authored by several Notre Dame researchers, has been published in PLOS ONE. The article, “Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya,” explores the results of a study on person-centered maternity care (PCMC) in a peri-urban setting in Kenya.

Peri-urban settings, areas located adjacent to a city or urban area, have high maternal mortality and the quality of care received varies in different types of health facilities. Few studies have explored the concept of PCMC within these settings, many of which lack access to basic amenities.  In these environments, women seeking maternal care face long wait times, overcrowded and under-resourced facilities, abuse and disrespect from doctors, nurses and hospital staff.  PCMC is a scale that can help us understand women’s experiences receiving maternal care; it measures women’s experiences in such settings. The scale can assess the interpersonal dimensions of quality of care, women’s involvement in decision-making about their care, if and how women are communicated with while receiving care, and if they are treated with dignity.

The article came out of a study done through the Ford Program in Human Development Studies and Solidarity and was co-authored by Danice Guzmán, associate director of the Pulte Institute for Global Development’s Evidence and Learning Division,  Laura Miller-Graff, Professor of Psychology and Peace Studies, Cindy Makanga, research project manager with the Ford Program, and Jackline Oluouch-Aridi, director of Notre Dame International in Nairobi, Kenya. The Notre Dame team also partnered with Patience Afulani, assistant professor of Epidemiology and Biostatistics at the University of California, San Francisco School of Medicine, who is the creator of the PCMC scale.

The study analyzed data from 307 women recruited from public, private, and faith-based facilities in Embakasi, Nairobi, Kenya and measured PCMC using a 30-item validated PCMC scale evaluating women’s experiences of dignified and respectful care, supportive care, and communication and autonomy. 

The results showed that the average PCMC score was 58.2(SD = 13.66) out of 90. The study concluded that women’s education, antenatal care timing and duration, and type of delivery provider are all factors related to women’s PCMC scores in these settings.  The authors encouraged providers to focus on aspects of supportive care, as well as effective communication and women’s autonomy, to improve quality of care for the women of Embakasi. 

“One methodological finding I thought was interesting was that scores varied based on the mode of interview, which we had to adapt throughout the study due to COVID restrictions.” said Guzmán. “Women rated their maternal care experience lower when they were interviewed by phone vs in the health facility itself.  This suggests positive bias when they were interviewed in the facility they were describing.” 

Health facility managers and policymakers can use the results of the study to better understand women’s experiences in maternity care and improve services in these settings. 

PLOS ONE is an “inclusive journal community working together to advance science for the benefit of society, now and in the future.” The research published is multidisciplinary and often interdisciplinary, and is previously evaluated based on the basis of scientific validity, rigorous methodology, and high ethical standards. 


Originally published by Alexandra Bendixen at on November 01, 2021.