Reading about preferred childbirth facilities in Tanzania, I could not help imagining the mothers’ Yelp reviews of various experiences. Although this idea is an exercise in imaginative thinking on one hand, it also forced me to reflect on where consumers gain information prior to making decisions and what factors influence these decisions. For my own decisions about something as seemingly simple as selecting a restaurant for dinner, I often find myself turning to the advice of fellow Yelpers (i.e., those that rate and review numerous categories of services online).
Although the women of Tanzania are not poring over the electronic reviews of their friends and neighbors, the data in Kruk, et al. (2009) certainly suggest that these women are investigating their childbirth facilities prior to delivery. If their friends’ advice was catalogued on Yelp, the most popular review, given that only 36.4% of women delivered their children in healthcare facilities, might read: “Just stay at home. It’s easier not to travel and be in the comfort of your own surroundings and support system.”
However, the women who did travel to a facility to give birth echo concerns comparable to the women of New York on Yelp when deciding on where to deliver. Similar themes of quality and trust emerge from reviews of New York ob/gyn facilities (although these reviews are not exclusive to those in childbirth). Tanzanian women who had “stronger preference for quality…, lower perceived quality of care at the nearest facility, and greater trust in health workers” (Kruk, et al., 2009) were more likely to bypass the facility nearest to them. Dolores on Yelp similarly wrote in a five-star review: “She’s the best ob/gyn I’ve ever had: patient, funny, understanding, and totally on top of the latest in research and practice. Despite being part of a very busy practice, she always manages to make the time she spends with you focused completely on you.” Here, Dolores emphasizes quality in treatment options, such as “being on top of the latest in research and practice,” as well as the quality of and trust in the healthcare worker.
These two groups of women also shared perceptions of the characteristics of a negative experience. In a two-star review by Amanda, she writes “Horrible reception, bankers hours (seriously–you have about a two hour window to call in there), snooty atmosphere, long wait times, non-existent follow-up AND, dare I say it, misinformation.” This New Yorker voices Tanzanian women’s concerns about poor quality (“misinformation”). provider attitude (“snooty atmosphere”), and management (“horrible reception,” “long wait times”).
Surprisingly, I found that in most of the reviews on Yelp, long wait times for obtaining appointments and at the appointment itself, were overshadowed when care and treatment was high-quality. Again, this trend seems to hold for Tanzanian women as well.
While these musings do not merit scientific status, they do emphasize the parallel preferences of women, regardless of country or economic status, for higher quality of care over more logistically accessible facilities.
Kruk, M., Mbaruku, G., McCord, C., Moran, M., Rockers, P., & Galea, S. (2009). Bypassing primary care facilities for childbirth: A population-based study in rural Tanzania. Health and Policy Planning, 24(4), 279-288. doi: 10.1093/heapol/czp011
Yelp. (2011). Ob/gyn Manhattan. Retrieved from http://www.yelp.com/search?find_desc=ob%2Fgyn&ns=1&find_loc=25+orchard+st+manhattan+ny