Relationships Matter in Quality Maternal Care: Qualitative Findings from a Community Health Center in Jakarta, Indonesia

Abstract

Background: Indonesia has a population of over 69 million women of reproductive age and struggles to reduce national maternal mortality rates. The transitioning health system must contend with improving the quality of maternity care. This study aimed to investigate the provision of maternity care from the perspective of two key stakeholders: providers and clients. Methods: We conducted individual, in-depth qualitative interviews with 31 pregnant and postpartum mothers and held two focus group discussions with 10 midwives in a community health center to examine attitudes and perceptions of quality maternity care. We then analyzed data through mapping emergent themes to the WHO QMNC framework. Results: Participants across both groups most frequently referenced interpersonal relationships, more than physical or human resources, as the main determinate to perceptions of quality care. Additionally, socioeconomic, religious and cultural factors also played a significant role in the provision of care; yet, was not fully captured in the definition of quality care. Conclusions: Interpersonal relationships are critical components to the provision of quality care. Investments in further fostering these relationships are important in strengthening the capability of the health system to provide safe, effective and high quality maternity care.