Background: Aim of this study was to determine the dimensions of the service quality in the
public hospitals and evaluate the determinants of client satisfaction in obstetric health in the
context of Pakistan. Methods: The present research evaluates the application of an integrated
client satisfaction model that draws mainly from the original SERVQUAL framework in obstetric
health services. We conducted a cross-sectional study, in four public district hospitals in Pakistan,
enrolling 1101 clients attending obstetric health care services. Measures of service quality and
determinants of client satisfaction were factor-analysed and multiple regression analysis was used
to test the hypothesis. Results: The client satisfaction increased significantly with increases in
respondent's age, number of children, number of visits and with decrease in educational status.
Factor analysis revealed five service quality dimensions; and multiple regression analysis showed
that all five dimensions of service quality in obstetric care were significant in explaining client
satisfaction. The most powerful predictor for client satisfaction was provider communication with
clients, followed by responsiveness and discipline. Conclusions: Interventions aimed at
improving client provider interaction would not only advance the clinical provision of services,
but would also result in greater patient satisfaction with the services provided, leading to higher
levels of facility utilization and continuity of care. Better client provider interaction can be
accomplished at hospital’s level through focused training of all cadre of service providers
sensitizing them on clients’ needs. Results also showed that the proposed framework is a valid and
flexible instrument in assessing and monitoring service quality and enabling staff to identify where
improvements are needed, from the clients' perspective.