Abstract
Antenatal care (ANC) is a critical intervention, and providing high-quality care results in positive maternal and neonatal outcomes. A facility-based cross-sectional study design was used among 4 public health facilities in Dessie Town, and 421 pregnant mothers were selected by a systematic random sampling technique. Data were collected using observation and interview through a pretested questionnaire, then entered and analyzed using EpiData 4.7 and SPSS 26. Finally, predictors of the quality of the ANC service were identified using multivariate logistic regression. Overall, 270 women (64%) were satisfied with ANC services in this study. Only 49 (70%) attributes of structural quality and 32 items (69.56%) of process quality attributes were met, which is inadequate and needs improvement. Mothers aged 20 to 24 (AOR = 3.067; 95% CI = 1.416, 6.641); mothers who took 30 min and more to get to the health facility (AOR = 2.745; 95% CI = 1.475, 5.111); mothers who had a choice of care providers (AOR = 2.829; 95% CI = 1.676, 4.777); merchants (AOR = 2.310; 95% CI = 1.077, 4.955); and farmers (AOR = 2.111; 95% CI = 1.138, 3.8) were positive predictors of women's satisfaction with ANC services. Although ANC client satisfaction was good, structure-quality attributes and process-related quality were inadequate and needed significant improvement. This implies that urgent interventions are needed to improve process and input quality attributes.