Client satisfaction with the quality of maternal healthcare services among immunization clinic attendees in selected primary healthcare facilities in Cross River State, Nigeria: a rural - urban comparison.

The increasing number of maternal deaths is a major global health concern. Most causes of these deaths are preventable through provision of quality maternal healthcare services (MHS). Client satisfaction has been recognized as an important indicator of healthcare quality. This study aimed to compare client satisfaction with MHS in selected rural and urban health facilities in Cross River State. A cross-sectional comparative study conducted among 466 mothers accessing immunization services recruited using a systematic sampling technique. Data was collected using an interviewer-administered questionnaire and analysed using SPSS version 25, employing bivariate analysis at (p<0.05). The overall mean age of respondents was 26.51±5.8 years. A significantly higher proportion of clients in the urban (92.2%) compared to the rural (81.5%) were satisfied with MHS (p=0.001). Clients' satisfaction level were significantly higher in the urban compared to the rural, (input: 56.4% rural, 76.1% urban, process: 85.8% rural, 93.7% urban; outcome: 96.2% rural, 100% urban). At bivariate analysis, only marital status was found to be associated with MHS satisfaction and among married women residing in urban setting. Therefore, interventions targeting improvement across all domains in the rural and input domain in the urban facilities is strongly recommended.