scholarly journals Exploring the Feasibility of using a four-day Training Program to Change the Culture of Disrespect and Abuse in Maternity Care in Ghana

2020 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Adwoa Bemah Boamah Mensah ◽  
Emmanuel Kweku Nakua ◽  
Alberta Lomotey ◽  
Pascal Agbadi ◽  
...  
Keyword(s):  
Training Program ◽  
Maternity Care ◽  
Cost Effective ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Interactive Mode ◽  
Middle Income Countries ◽  
Focused Antenatal Care

Abstract Objectives To improve childbirth experiences for childbearing women in healthcare facilities in low-and-middle-income countries, it is important to implement a cost-effective intervention to change the culture of disrespect and abuse in maternity care. Thus, we explored the feasibility of using four Respectful Maternity Care Modules in a training program to change the culture of disrespect and abuse in maternity care in a teaching hospital in Kumasi, Ghana.Results Midwives were trained on respect and dignity in childbirth, effective communication, focused antenatal care, and the use of alternative birthing positions for delivery. The statistical test revealed a statistically significant increase in knowledge of RMC following participation in the RMC-M training, z = − 3.43, p = 0.001, with a large effect size (r = 0.63). The median score on the self-developed Respectful Maternity Care Questionnaire increased from pre-program (Md = 10) to post-program (Md = 15). The experts remarked that the content of the training was adequate to enhance midwives’ knowledge, skills, and attitude to provide respectful maternal care. They recommended the inclusion of teaching methods that engages the adult learner in an interactive mode.

scholarly journals Exploring midwives’ understanding of respectful and non-abusive maternal care in Kumasi, Ghana: Qualitative Inquiry

2019 ◽  
Author(s):  
Dzomeku Veronica Millicent ◽  
Bonsu Adwoa Bemah ◽  
Nakua Kweku Emmanuel ◽  
Agbadi Pascal ◽  
Lori R. Jody ◽  
...  
Keyword(s):  
Maternity Care ◽  
Maternal Care ◽  
Study Data ◽  
Qualitative Inquiry ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Evidenced Based

AbstractBackgroundVarious aspects of disrespect and abusive maternity care have received scholarly attention because of frequent reports of the phenomenon in most healthcare facilities globally, especially in low- and middle-income countries. However, the perspectives of skilled providers on respectful maternal care have not been extensively studied. Midwives’ knowledge of respectful maternity care is critical in designing any interventive measures to address the menace of disrespect and abuse in maternity care. Therefore, the present study sought to explore the views of midwives on respectful maternity care at a Teaching Hospital in Kumasi, Ghana.MethodsPhenomenological qualitative research design was employed in the study. Data were generated through individual in-depth interviews, which were audio-recorded and transcribed verbatim. Data saturation was reached with fifteen midwives. Open Code 4.03 was used to manage and analyse the data.FindingsThe midwives’ understanding of respectful maternity care was comprised of the following components: non-abusive care, consented care, confidential care, non-violation of childbearing women’s basic human rights, and non-discriminatory care. Probing questions to solicit midwives’ opinions on an evidenced-based component of respectful maternity care generated little information, suggesting that the midwives have a gap in knowledge regarding this component of respectful maternity care.ConclusionMidwives reported an understanding of most components of respectful maternity care, but their gap in knowledge on evidenced-based care requires policy attention and in-service training. To understand the extent to which this gap in knowledge can be generalized for midwives across Ghana to warrant a redesign of the national midwifery curriculum, the authors recommend a nationwide cross-sectional quantitative study.

scholarly journals From Global Rights to Local Relationships: Exploring Disconnects in Respectful Maternity Care in Malawi

2019 ◽  
Vol 30 (3) ◽  
pp. 341-355
Author(s):  
Bregje Christina de Kok ◽  
Isabelle Uny ◽  
Mari Immamura ◽  
Jacqueline Bell ◽  
Jane Geddes ◽  
...  
Keyword(s):  
Maternity Care ◽  
International Standards ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Middle Income ◽  
Middle Income Countries ◽  
Client Relationships ◽  
Local Contexts ◽  
Respectful Care ◽  
Current Emphasis

Widespread reports of “disrespect and abuse” in maternity wards in low- and middle-income countries have triggered the development of rights-based respectful maternity care (RMC) standards and initiatives. To explore how international standards translate into local realities, we conducted a team ethnography, involving observations in labor wards in government facilities in central Malawi, and interviews and focus groups with midwives, women, and guardians. We identified a dual disconnect between, first, universal RMC principles and local notions of good care and, second, between midwives and women and guardians. The latter disconnect pertains to fraught relationships, reproduced by and manifested in mechanistic care, mutual responsibilization for trouble, and misunderstandings and distrust. RMC initiatives should be tailored to local contexts and midwife-client relationships. In a hierarchical, resource-strapped context like Malawi, promoting mutual love, understanding, and collaboration may be a more productive way to stimulate “respectful” care than the current emphasis on formal rights and respect.

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Maternity Care ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.Methods An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.Results The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Maternity Care ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.Methods An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.Results The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative

scholarly journals Factors influencing whether or not male partners from low and middle income countries attend childbirth: a mixed methods systematic review

2019 ◽  
Author(s):  
Thierry UHAWENIMANA
Keyword(s):  
Maternity Care ◽  
Emotional Experience ◽  
Respectful Maternity Care ◽  
Limited Information ◽  
Male Partners ◽  
Middle Income ◽  
Middle Income Countries ◽  
Factors Influencing ◽  
Potential Benefits ◽  
Low And Middle Income

Abstract Currently, there is a global drive to promote respectful maternity care including a woman’s right to have a companion of her choice during labour and birth. This may include but is not limited to doula, female relatives or friends, and male partners. Evidence suggests that male partners’ attendance at childbirth, when it is a woman’s choice, may be associated with a positive emotional experience for the woman. However, these potential benefits were reported from studies conducted in high income settings only. There is limited information about male partners’ attendance at labour and birth in low and middle income countries (LMICs). Although male partners’ attendance at childbirth is being implemented in a few health facilities in LMICs, there is a paucity of evidence on the acceptability and feasibility of this practice and the moderators of implementation in the context of LMICs.

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Maternity Care ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background: Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana. Method: An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data. Findings: The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward. Conclusion: The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative

Midwifery leadership, advocacy and action to improve maternal health in PNG

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Hall ◽  
J Kep ◽  
J Brown ◽  
J Pyakalyia ◽  
R King ◽  
...  
Keyword(s):  
Maternal Health ◽  
Peer Support ◽  
Leadership Training ◽  
Maternity Care ◽  
Universal Access ◽  
Middle Income ◽  
Improvement Project ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Innovative Model

Abstract Background The SDG target for maternal mortality is less than 70 per 100,000 live births; in Papua New Guinea, it is estimated to be 145. PNG will require significant resources and strong leadership to meet the 2030 target. The PNG Midwifery Leadership Buddy Program (Buddy Program), funded and coordinated by Rotary, offers an innovative model to improve maternal health, which may be transferable to other low-middle-income countries. Objectives The Buddy Program aims to build midwifery leadership resulting in improved outcomes in PNG. As partners, midwives from PNG and Australia undertake leadership training in Port Moresby and enter a reciprocal peer support relationship. Over 12 months, they support each other in their professional roles and progress a quality improvement project. Results Three cohorts of midwives (18 from each country), have participated in the leadership training and the first group has completed 12 months of peer support. Participants have reported increased confidence for leadership, action and advocacy. There has been some communication challenges and variation in expectations, predominately due to cultural differences. The Buddy Program has resulted in a number of tangible projects including the introduction of family planning education at a local school and University, introduction of respectful care in pregnancy charter and increased surveillance and treatment of pregnant women with anaemia. Interestingly, a number of participants have continued to support each other beyond the initial 12-month commitment. Conclusions Supportive partnerships that grow midwifery leadership hold significant potential to increase the quality of maternity care and reduce preventable maternal deaths in low-middle-income countries. Key messages Midwifery leadership plays a vital role in addressing the SDG targets for maternal health. The Buddy Program offers an innovative model to progress the agenda for universal access to quality maternity care.

scholarly journals Achieving Viral Suppression in 90% of People Living With Human Immunodeficiency Virus on Antiretroviral Therapy in Low- and Middle-Income Countries: Progress, Challenges, and Opportunities

2018 ◽  
Vol 66 (10) ◽  
pp. 1487-1491 ◽  
Author(s):  
Jean B Nachega ◽  
Nadia A Sam-Agudu ◽  
Lynne M Mofenson ◽  
Mauro Schechter ◽  
John W Mellors
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Suppression ◽  
Cost Effective ◽  
Term Treatment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Long Term Treatment ◽  
Wide Range ◽  
Immunodeficiency Virus ◽  
Low And Middle Income

Abstract Although significant progress has been made, the latest data from low- and middle-income countries show substantial gaps in reaching the third “90%” (viral suppression) of the UNAIDS 90-90-90 goals, especially among vulnerable and key populations. This article discusses critical gaps and promising, evidence-based solutions. There is no simple and/or single approach to achieve the last 90%. This will require multifaceted, scalable strategies that engage people living with human immunodeficiency virus, motivate long-term treatment adherence, and are community-entrenched and ‑supported, cost-effective, and tailored to a wide range of global communities.

Midwives' perceptions of disrespect and abuse of women during labour and childbirth in Lusaka, Zambia

2021 ◽  
Vol 15 (3) ◽  
pp. 1-12
Author(s):  
Namayipo Stella Wamukankamba Nankamba ◽  
Catherine Mubita Ngoma ◽  
Maureen Masumo Makoleka
Keyword(s):  
Logistic Regression ◽  
Maternity Care ◽  
Health Workers ◽  
Multivariate Logistic Regression Analysis ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Multivariate Logistic Regression ◽  
Abuse Of Women ◽  
And Training

Background/Aims Disrespect and abuse is a frequent occurrence in labour wards around the world. Disrespect and abuse during care by health workers can prevent pregnant women from seeking care during labour and childbirth, which can lead to increased maternal and neonatal mortality rates. This study aimed to explore midwives' perceptions of disrespect and abuse of women during labour and childbirth in Lusaka. Methods A concurrent convergent mixed-method approach was used for this study. Data were collected through a self-administered questionnaire given to 217 midwives actively practicing in maternal health services across Lusaka randomly sampled for the quantitative arm of the study. The data were analysed using bivariate and multivariate logistic regression, with P<0.05 used to indicate significance. For the qualitative component of the study, 13 purposively selected key informants were interviewed with an interview guide. Results Most of the respondents (88.5%) perceived disrespect and abuse of women during labour and childbirth as a negative phenomenon. However, almost half (40.1%) had provided care which was disrespectful and abusive during their practice and the majority (68.7%) had observed disrespect and abuse by other midwives. Bivariate and multivariate logistic regression analysis found an association between midwives' perception of disrespect and abuse and witnessing or participating in disrespectful and abusive behaviour during practice. In the qualitative arm of the study, midwives reported that disrespect and abuse occurred in labour wards across Lusaka, demonstrating an urgent need to prevent such practices. Midwives suggested actions such as increased sensitisation and training of midwives on respectful maternity care and improved staffing levels as ways to prevent this practice Conclusions Disrespect and abuse of women during labour and childbirth should be prevented. Increasing health education and training for both the public and midwives on respectful maternity care can help to achieve this goal. Midwives need to be motivated through good working environments, increased wages and increased time to rest while working, as the heavy workload was found to contribute to disrespect and abuse in labour wards.

Sign in / Sign up

Export Citation Format

Share Document