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ST. MARY MATERNITY HOSPITAL: INTRODUCTION TO SPSS AND
STATISTICAL ANALYSIS
Dr. Satyendra Singh and Dr. Meera Kaur wrote this case solely to provide material for class discussion. The authors do not intend to
illustrate either effective or ineffective handling of a managerial situation. The authors may have disguised certain names and other
identifying information to protect confidentiality.
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Copyright © 2012, Richard Ivey School of Business Foundation
Version: 2012-08-01
Established in 1947, St. Mary Maternity Hospital (MMH) — a nonprofit organization — had a mission to
deliver healthy babies with normal weights, and to offer medical care to expectant mothers regardless of
their ability to pay. Since its inception, the MMH had enjoyed a reputation for achieving its mission. In
fact, in 2005, the Regional Health Authority (RHA) rated the MMH among the top 25 best performing
maternity hospitals in India in three categories: proper recording of data relating to expectant mothers,
appropriate involvement of obstetricians and midwives in prenatal care and providing mothers with basic
advice on infant feeding. However, in 2010, its reputation deteriorated so much so that the RHA rated the
MMH among the bottom 25 per cent for its maternity services. Dr. Rita Maharaj, Chief Medical Officer
(CMO) of the MMH, was under pressure to improve the rating of the hospital, as the future funding
depended on living up to the expectations of the stakeholders such as doctors, nurses, other allied health
professionals (AHP) and administrators. As a result, Maharaj, needed to conduct a survey of expectant
mothers to understand the issues and their implications for stakeholders. Delivering healthy babies with
normal weight was crucial to achieving MMH’s mission.
ST. MARY MATERNITY HOSPITAL
To achieve their mission, the MMH doctors, nurses and AHPs worked hard with expectant mothers to
live up to their expectations for high quality maternity services. They particularly paid attention to
expectant mothers with little or no formal education, in which case, doctors and nurses had an extra
responsibility to educate and create awareness about prenatal care such as proper nutritional care, regular
health check-up, blood work and immunization. Success of MMH’s mission depended on delivery of
healthy babies with normal weights.
Dr. Julia Albert had been CMO of the hospital since 1995, during which time she took great care in
achieving the mission of the hospital and in raising funds for operation of the hospital through grants and
donations. Under her leadership until December 2005, the RHA rated MMH among the top 25 best
performing maternity hospitals in the Northern India. MMH received an average score of 4.6 on a 5-point
scale on 25 performance indicators. In fact, MMH received five out of five in three categories: proper
This document is authorized for use only in Prof. Goutam Sutar's Data Analysis for Management-I at Thiagarajar School of Management (TSM) from Aug 2022 to Jan 2023.
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recording of data relating to expectant mothers, the appropriate involvement of obstetricians and
midwives in antenatal care, and providing mothers with basic advice on infant feeding. Proud of this
accomplishment, Dr. Albert announced her retirement in December 2005, and left India for good to spend
the rest of her life in her homeland, England. In January 2006, the MMH Board of Trustees appointed a
locally trained CMO — Dr. Rita Maharaj.
However, in December 2010, Maharaj was shocked to learn the RHA rated the MMH among the bottom
25 per cent for its maternity services. According to the RHA report, about 10 per cent of expectant
mothers, who were surveyed immediately after giving birth to a baby stated that, although MMH
provided prenatal education to about 40 per cent of expectant mothers who needed it, the great majority
did not adhere to the basic advice, such as impact of smoking during pregnancy on the baby’s health, the
effect of mother’s age on baby’s weight, the importance and benefits of breast feeding, and the
importance of maternal and child nutrition throughout pregnancy. It was also revealed that only about 50
per cent of women at MMH were able to fully understand the prenatal sessions compared to the national
average of 60 per cent. MMH was also penalized for failing to provide statistics regarding breastfeeding,
mother’s educational qualification, birth order of baby and smoking behavior during pregnancy, among
other factors. Only 38 per cent of women said they were happy with the quality of support they received
prior to hospitalization, during hospitalization and after discharge.
Following release of the RHA report, Peter Rao, chairman of the MMH Board of Trustees, said, “Dr.
Maharaj, we are disappointed to read the recent report about the MMH. This is not what we stand for. We
would like a full review of the maternity services. We have significantly invested in MMH in 2011 and
committed extra funding for the future. We are dedicated to continually improving the maternity services.
Please submit your recommendations to the board by the end of December 2012 as to how to improve the
rating conducted by the RHA.”
Maharaj was under pressure to improve the rating of the hospital. She was also aware MMH received
$300,000 in 2011 for the refurbishment of MMH from a local philanthropist, Dr. David Greenburg. Dr.
Greenburg said, “The support is to help strengthen the hospital as a referral healthcare facility to enrich
the lives of expectant mothers and babies.” Maharaj knew obtaining future funding would be difficult
with this low rating. She knew she needed to conduct a survey of expectant mothers to understand all the
issues and their implications for doctors, nurses, AHPs and administrators.
After returning to her chamber, Maharaj called her deputy, Dr. Ruby Kite, and said, “We need to
investigate the issues and questions that have arisen in the recent MMH Board of Trustees’ meeting. We
need to know what the numbers are telling us. We need to be as specific as we can to make actionable
recommendations to the board. Please send me your recommendations by the end of November 2012.”
To answer the questions and to develop insights, Dr. Kite surveyed the birth recovery ward at the hospital
and collected responses from 33 mothers. Their responses appear in Exhibit 1.
This document is authorized for use only in Prof. Goutam Sutar's Data Analysis for Management-I at Thiagarajar School of Management (TSM) from Aug 2022 to Jan 2023.
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9B12E009
Exhibit 1
MMH DATASET CHARACTERISTICS
Overall
satisfaction
5
4
3
4
5
4
Gender
2
3
1
6
2
1
Baby
weight
in kg
2.53
2.49
1.75
1.70
2.87
2.67
Boy
Boy
Girl
Boy
Boy
Girl
smoke
while
pregnant
Yes
Yes
No
No
No
No
18
1
3.41
3
Girl
Yes
19
22
34
30
23
25
29
29
28
24
23
36
30
24
32
28
29
31
1
2
2
1
1
3
2
4
2
3.20
2.80
2.97
2.85
3.45
2.63
2.86
2.69
2.88
3
3
4
4
5
4
5
4
3
Boy
Boy
Boy
Boy
Boy
Girl
Girl
Girl
Girl
17
26
54
1
3.97
4
18
19
20
21
22
23
38
30
27
31
26
42
33
29
23
1
3
2
2
1
3.56
2.97
2.92
3.24
3.30
23
24
25
26
27
28
29
23
22
26
40
35
31
19
27
26
26
38
42
40
22
1
3
2
1
1
3
1
30
31
32
33
20
27
19
26
22
27
24
28
2
1
1
2
ID
1
2
3
4
5
6
Age
(yr)
mother
27
21
23
37
31
21
Age
(yr)
father
29
26
23
36
21
27
7
16
8
9
10
11
12
13
14
15
16
Birth
order
Prenatal
session
attendance
Yes
Yes
No
No
Yes
Yes
Father’s
Education
level
7
5
4
8
3
1
Yes
3
No
Yes
No
No
No
No
No
Yes
Yes
mother’s
education
level
2
4
6
4
14
No
education
No
education
8
5
Missing
16
7
2
6
11
1
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Boy
No
5
Yes
2
3
5
3
6
Girl
Girl
Boy
Girl
Boy
Yes
No
No
No
No
5
12
1
3
6
No
Yes
Yes
Yes
Yes
3.29
3.18
2.99
1.58
2.67
2.19
Missing
4
3
2
3
3
4
4
Girl
Girl
Girl
Boy
Boy
Girl
Girl
No
Yes
No
Yes
Yes
No
No
6
6
3
4
2
7
4
Yes
Yes
Yes
No
No
Yes
Yes
3.40
2.79
1.97
4.40
4
3
3
4
Girl
Boy
Girl
Boy
Yes
Yes
No
No
3
2
8
14
Yes
No
No
No
5
5
14
14
4
2
3
3
No
education
No
education
6
9
11
10
No
education
4
7
8
5
1
3
No
education
3
3
9
10
Overall satisfaction is measured on a 5-point scale where 1= not satisfied, and 5= very satisfied.
Source: MMH records.
This document is authorized for use only in Prof. Goutam Sutar's Data Analysis for Management-I at Thiagarajar School of Management (TSM) from Aug 2022 to Jan 2023.