Evaluation of an Amharic-Language translation of Continuity of Care Satisfaction Tool among Postnatal Mothers in Ethiopia

Abstract Background: Beginning in the 1990s, women’s dissatisfaction with maternity services has been widely reported in the literature. However, there is a lack of consistency in the studies published over the three decades since then. The nature and availability of maternity services vary widely from country to country and even in single countries, the United States for example, there is no such thing as nationally uniform maternal care. We need cross cultural validated tools to measure women’s satisfaction with maternity care. The study reported here aimed to develop a valid and reliable continuity of care satisfaction scale for use in Ethiopia, first by finding an appropriate English-language model and then translating that into an Amharic language version that in an appropriately modified form could be used for studies of postnatal mothers in Ethiopia. Methods: An Amharic-language translation of a satisfaction with continuity of care tool was prepared based on an English-language questionnaire and this was then back translated. A team of experts analyzed the Amharic-language questionnaire as concerns the following elements: Face and content validity; quality of the forward and back translations; expert panel and pre-testing of the tool. A facility-based cross-sectional study was conducted among 329 postnatal mothers in Debre Berhan town health facilities, Ethiopia using the Amharic version of the questionna ire. Internal consistency of the tool (reliability) was checked by using Cronbach’s alpha. We extracted a new factor structure by carrying out exploratory factor analysis (EFA). For the extracted factor structure, confirmatory factor analysis (CFA) was conducted, and the model fit was assessed. Results: The translated tool was found to be acceptable by the experts and target groups. EFA yielded two subscales for each component of maternity care: “information provision and relationship with care providers” and “women’s self-assessment on quality of care”. The extracted factor structure had good convergent and discriminant validity. The tool has overall Cronbach’s α value of 0.94. All three domains have acceptable internal consistency with α value of >0.70. CFA 3 revealed a satisfactory fit between the questionnaire data and the model which provides support for the suggested factor structure identified by EFA. Conclusion: This study confirmed that the Amharic-language continuity of care satisfactio n evaluation tool is a valid tool for in future studies evaluating Ethiopian women’s satisfaction with maternity care. The results from such studies could be used to aid in a trial of the continuity of care model in Ethiopia.