Antenatal Care (ANC) Services Quality Analysis of Pregnant Women’s Satisfaction

Abstract

Puskesmas Bungus recorded high coverage for K1 (94.3%) and K4 (92.4%) visits; however, which dimensions of antenatal care (ANC) quality most influence pregnant women's satisfaction remain unclear. This study aimed to analyse pregnant women's satisfaction with ANC quality based on expectations versus actual experience across the SERVQUAL and SERPERF dimensions, and to identify the dimension most strongly influencing satisfaction at Puskesmas Bungus. A mixed-methods sequential explanatory design was employed. The quantitative sample comprised 113 pregnant women selected via accidental sampling, analysed using chi-square testing, multiple logistic regression, and Importance-Performance Analysis. Qualitative data were obtained from six informants through in-depth interviews and analysed using structured thematic analysis. Bivariate testing showed all five SERVQUAL dimensions were significantly associated with satisfaction (p<0.05). Gap analysis revealed tangibles as the only dimension with a negative gap (−0.282). Multivariate analysis identified tangibles as the most dominant predictor of satisfaction (OR=125.434, p=0.002). Qualitative findings confirmed constraints including prolonged waiting times (1–2 hours), limited physical facilities, inadequate privacy, and insufficient communication during the standard 10T examination. All SERVQUAL dimensions were significantly associated with satisfaction, with tangibles being the most dominant factor and the only unmet expectation. Strengthening physical facilities and queue efficiency should be prioritised.