Maternal satisfaction with free delivery services: a cross-sectional study at Lisanga and Saint Gabriel health centers in the Lemba health zone, Kinshasa, Democratic Republic of the Congo

Abstract

Since the implementation of free maternal healthcare services in the Democratic Republic of the Congo (DRC), concerns have emerged regarding the quality of care provided. This cross-sectional study assessed satisfaction among women who benefited from free childbirth services at Saint Gabriel and Lisanga Health Centers in the Lemba Health Zone, Kinshasa. From June 30 to July 30, 2024, 385 postpartum women who had delivered and stayed for at least 24 h were interviewed using a structured questionnaire adapted from a public health assessment tool. Data were collected through face-to-face interviews and analyzed using SPSS version 20. Descriptive statistics were computed, and composite scores were used to assess satisfaction dimensions. The mean age was 28.7 ±  6.0 years. Most participants were married (88.1%), multiparous (59.0%), or homemakers (58.7%). Overall satisfaction was 99.7%. Satisfaction was 97.4% for medical care and 99.7% for interactions with healthcare providers. However, 15.6% of participants reported out-of-pocket payments despite the free care policy, mainly for medications. Although the services were generally perceived as satisfactory, these payments indicate implementation gaps. Strengthened regulation, continuous supervision, accountability mechanisms, and community awareness are needed to ensure effective enforcement and improve equity, trust, and quality in maternal health services.