Table 1. Donabedian model of measuring health care system performance.

Independent Variable	Service	Process	Dependent variable (Outcome)
Treatment process	Diagnosis of Pain and any other health condition before during labour and after delivery.	Prompt diagnosis and provision of adequate drug to control pain during labour and delivery leads client’s satisfaction.	Client satisfaction with quality of care
Stages of treatment	Pain relief during labour, Pain relief after delivery, and Emotional Support.	Use of efficacious drugs during labour and delivery will make clients comfortable, satisfied and may develop interest in use of the same facility or recommend it to another patient. Offering emotional support to a mother in labour by midwife or birth attendant yield better outcome of labour
Appropriateness	Health Provider Technical competence in care of clients/patients	Use of the equipment in the health facility for detecting women’s and baby’s condition during labour and delivery and after delivery will lead to a successful outcome for mother and baby
	Privacy and confidentiality	Maintaining privacy during procedures like examination during labour and delivery and asking them questions or responding to their needs in confidence boost clients self-esteem and will influence their level of satisfaction
	Emotional support during labour and delivery	The extent to which clients /patients emotional needs are met during labour and delivery leads to confidence, self-esteem of the client satisfaction.
	Care by provision of information after delivery and on discharge.	The prompt care after delivery which includes provision, which danger signs to observe in self and in baby, information on self-care and care of the baby has a role in influencing clients’ satisfaction with the services.
Service process	Timeliness (waiting time.)	Attending the Clients/Patient promptly reduces unnecessary delays which may result into adverse outcomes and this positively influences overall satisfaction with care.