Effects of customer self-audit on the quality of maternity care in Tabriz: A cluster-randomized controlled trial

ObjectiveTo study the effects of customer self-audit on the service quality (SQ) and customer quality (CQ) of maternity care.DesignA community-based cluster-randomized controlled trial.SettingTwenty-one health centres and health posts in Tabriz, Iran.ParticipantsOf 21 health centres/health posts, 10 were randomly assigned to the intervention group and 11 randomly assigned to the control group. Participants were 185 pregnant women selected from health centre/post registration lists (intervention group: n = 92; control group: n = 93).InterventionsThe intervention was a customer self-audit based on the CenteringPregnancy® model of prenatal group care. The intervention group attended group support sessions focused on participants’ opinions, questions, and self-management concerns. They also received sessions on experiential learning, coping, problem-solving, and goal-setting by a family health expert, a midwife, and a doctor. Control group participants continued to receive individual care.Primary outcome measuresSQ and CQ were assessed using questionnaires. Patients rated the importance and performance of non-health quality dimensions. SQ was calculated as: SQ = 10 − (Importance × Performance).ResultsTotal mean SQ scores were 7.63 (0.91) and 8.91 (0.76) for the control and intervention groups, respectively, a statistically significant difference (pConclusionsThe group prenatal care customer self-audit improved the SQ and CQ of maternity care by increased involvement of participants and giving them active roles in the care process.