Disrespect and Abuse During Facility‐Based Childbirth in North Showa Zone, Ethiopia

2020 ◽  
Author(s):  
Yohannes Mehretie Adinew ◽  
Helen Hall ◽  
Amy Marshall ◽  
Janet Kelly
Keyword(s):  
Maternity Care ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Public Health Facility ◽  
Respectful Maternity Care ◽  
P Value ◽  
Disrespect And Abuse ◽  
Structural Factors ◽  
Care Providers ◽  
Cross Sectional

Abstract Background: Respectful maternity care is a fundamental human right, and an important component of quality maternity care that every childbearing woman should receive. Disrespect and abuse during childbirth is not only a violation of a women’s rights, it is associated with a reduction in the number of women accessing professional maternity services and increases the risk of maternal mortality. This study investigated women’s experience of disrespect and abuse during facility-based childbirth in Ethiopia. Methods: A cross-sectional study was conducted with 435 randomly selected women who had given birth at public health facility within the previous twelve months in North showa zone of Ethiopia. A structured, researcher administered questionnaire was used with data collected using digital, tablet-based tools. Participants’ experiences were measured using the seven categories and verification criteria of disrespect and abuse identified by White Ribbon Alliance. Multivariable logistic regression was used to identify the association between experience of disrespect and abuse and interpersonal and structural factors at p-value < 0.05 and OR values with 95% confidence interval. Results: All participants reported at least one form of disrespect and abuse during childbirth. Types of disrespect and abuse experienced by participants were; physical abuse 435(100%), non-consented care 423(97.2%), non-confidential care 288 (66.2%), abandonment/ neglect (34.7%), non-dignified care 126(29%), discriminatory care 99(22.8%) and detention 24(5.5%). Hospital birth [AOR: 3.04, 95% CI: 1.75, 5.27], rural residence [AOR: 1.44, 95% CI: 0.76, 2.71], monthly household income less than 1,644 Birr (USD 57) [AOR: 2.26, 95% CI: 1.20, 4.26], being attended by female providers [AOR: 1.74, 95% CI: 1.06, 2.86] and midwifery nurses [AOR: 2.23, 95% CI: 1.13, 4.39] showed positive association with experience of disrespect and abuse. Conclusion: The level of disrespect and abuse is high and its drivers and enablers include both structural and interpersonal factors. Expanding the size and skill mix of professionals in the preferred facilities (hospitals), and sensitizing care providers and health managers regarding the magnitude and consequences of D&A are strategies that could possibly promote more dignified and respectful maternity care.

scholarly journals Respectful maternity care delivered within health facilities in Bangladesh, Ghana and Tanzania: a cross-sectional assessment preceding a quality improvement intervention

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039616
Author(s):  
Alexander Manu ◽  
Nabila Zaka ◽  
Christina Bianchessi ◽  
Edward Maswanya ◽  
John Williams ◽  
...  
Keyword(s):  
Emotional Support ◽  
Maternity Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Quality Improvement Intervention ◽  
Respectful Maternity Care ◽  
Care Providers ◽  
Social Scientists ◽  
Cross Sectional ◽  
Respectful Care

ObjectiveTo assess respectful maternity care (RMC) in health facilities.DesignCross-sectional study.SettingForty-three (43) facilities across 15 districts in Bangladesh, 16 in Ghana and 12 in Tanzania.ParticipantsFacility managers; 325 providers (nurses/midwives/doctors)—Bangladesh (158), Ghana (86) and Tanzania (81); and 849 recently delivered women—Bangladesh (295), Ghana (381) and Tanzania (173)—were interviewed. Observation of 641 client–provider interactions was conducted—Bangladesh (387), Ghana (134) and Tanzania (120).AssessmentTrained social scientists and clinicians assessed infrastructure, policies, provision and women’s experiences of RMC (emotional support, respectful care and communication).Primary outcomeRMC provided and/or experienced by women.ResultsThree (20%) facilities in Bangladesh, four (25%) in Ghana and three (25%) in Tanzania had no maternity clients’ toilets and one-half had no handwashing facilities. Policies for RMC such as identification of client abuses were available: 81% (Ghana), 73% (Bangladesh) and 50% (Tanzania), but response was poor. Ninety-four (60%) Bangladeshi, 26 (30%) Ghanaian and 20 (25%) Tanzanian providers were not RMC trained. They provided emotional support during labour care to 107 (80%) women in Ghana, 95 (79%) in Tanzania and 188 (48.5%) in Bangladesh, and were often courteous with them—236 (61%) in Bangladesh, 119 (89%) in Ghana and 108 (90%) in Tanzania. Due to structural challenges, 169 (44%) women in Bangladesh, 49 (36%) in Ghana and 77 (64%) in Tanzania had no privacy during labour. Care was refused to 13 (11%) Tanzanian and 2 Bangladeshi women who could not pay illegal charges. Twenty-five (7%) women in Ghana, nine (6%) in Bangladesh and eight (5%) in Tanzania were verbally abused during care. Providers in all countries highly rated their care provision (95%–100%), and 287 (97%) of Bangladeshi women, 368 (97%) Ghanaians and 152 (88%) Tanzanians reported ‘satisfaction’ with the care they received. However, based on their facility experiences, significant (p<0.001) percentages—20% (Ghana) to 57% (Bangladesh)—will not return to the same facilities for future childbirth.ConclusionsFacilities in Bangladesh, Ghana and Tanzania have foundational systems that facilitate RMC. Structural inadequacies and policy gaps pose challenges. Many women were, however, unwilling to return to the same facilities for future deliveries although they (and providers) highly rated these facilities.

scholarly journals Person-Centered Maternity Care During Childbirth and Associated Factors at Selected Public Hospitals in Addis Ababa, Ethiopia, 2021: A Cross-Sectional Study

2021 ◽  
Author(s):  
Azezew Ambachew Tarekegne ◽  
Berhanu Wordofa Giru ◽  
Bazie Mekonnen
Keyword(s):  
Health Care Providers ◽  
Maternity Care ◽  
Associated Factors ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: Person-centered maternity care is respectful and responsive care to individual women’s preferences, needs, and values and ensuring that their values guide all clinical decisions during childbirth. It is recognized as a key dimension of the quality of maternity care that increases client satisfaction and institutional delivery. However, little research has been conducted about person-centered maternity care in Ethiopia. Objective: The aim of this study was to assess the status of person-centered maternity care and associated factors among mothers who gave birth at selected public hospitals in Addis Ababa city, Addis Ababa, Ethiopia, 2021.Method: A facility-based cross-sectional study was conducted at selected public hospitals in Addis Ababa city. A semi-structured questionnaire was used to collect data from post-natal mothers selected by systematic random sampling. The data was coded and entered using Epi-data version 4.6 and analyzed using SPSS version 25. Bivariate and multivariable linear regression analysis was used to identify factors associated with person-centered maternity care. The strength of association between independent and dependent variables was reported by using unstandardized β at 95% CI and p-value < 0.05 were considered statistically significant.Results: In this study 384 mothers were participated with a response rate of 99.2%. The overall prevalence of person-centered maternity care was 65.8%. Respondents who had no ANC follow-up (β= -5.39, 95% CI: -10.52, -0.26), <4 ANC follow up (β= -3.99, 95% CI: -6.63, -1.36), night time delivery (β= -3.95, 95% CI: -5.91, -1.98) and complications during delivery (β= -3.18, 95% CI: -6.01, -0.35) were factors significantly associated with person-centered maternity care.Conclusion and Recommendations: The finding of this study showed that the proportion of person-centered maternity care among mothers who gave birth in public hospitals of Addis Ababa was high as compared to previous studies. The factors affecting person-centered maternity care are manageable to interventions. Therefore, Health care providers need to provide person-centered maternity care for all mothers.

scholarly journals An Innovative Intervention to Improve Respectful Maternity Care in Three Districts in Ethiopia

2019 ◽  
Author(s):  
Birkety Mengistu Jembere ◽  
Haregeweyni Alemu ◽  
Munir Kassa ◽  
Meseret Zelalem ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Maternity Care ◽  
Interrupted Time Series ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Experience Of Care

Abstract BackgroundDisrespect and abuse (D&A) during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, D&A has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care (RMC) and decrease D&A in three districts in Ethiopia.MethodsAs part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel RMC training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the RMC training in three districts within the regions of Oromia; Southern Nations, Nationalities, and People’s; and Tigray. Measures of births with privacy and a birth companion from a 27-month data from 17 health centers and three hospitals were analyzed using STATA version 13 for interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facilitated discussions were conducted among health care providers to gauge the effectiveness of the videos. Facility level solutions applied to enhance RMC were documented. ResultsAn analysis of the effectiveness of integrating RMC using available programmatic data showed significant improvement following the RMC training, which was sustained beyond the project intervention (regression coefficients ranging from 0.18 to 0.77). Several local solutions were devised and implemented in the health facilities to improve the experience of care for mothers. Facilitated discussions with health care providers participating in the RMC training showed improved understanding of patients’ perspectives and the psychosocial needs of their clients. ConclusionThis study suggests that integrating the RMC training into the district-wide quality improvement (QI) collaborative is effective in improving RMC. Use of testimonial videos are especially helpful as they remind providers of the need to treat mothers with dignity and helps them reflect on potential root causes for this type of treatment and develop effective solutions.

Hospital and Domiciliary Services Outcome: A Cross-Sectional Study on Married Women of Peshawar Khyber Pakhtunkhwa

2020 ◽  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cross Sectional Study ◽  
P Value ◽  
Hospital Services ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Domiciliary Care ◽  
Safe Delivery

Background: Antenatal care and effective services are the hallmarks of effective pregnancy outcome. Thus, practices by community care providers throughout labor and childbirth might affect health outcomes of newborns. There is a need for proper antenatal checkups in hospital and domiciliary care by community health workers and importance of antenatal care on pregnancy outcomes. Since, every woman has a right to safe delivery that must include proper labor management protocols. Therefore, the purpose of this study was to compare and assess the antenatal care of hospital based and domiciliary services on the outcome of delivery. Methods: This cross-sectional study was conducted from November 2018-April 2019. A sample size of about 300 married females was selected from different towns of Peshawar through non-probability convenient sampling technique. Data was collected using semi structured questionnaire after taking informed consent from the women. Data were analyzed by using SPSS. Chi square test was applied for associations between hospital and domiciliary services and antenatal outcomes in both setups. p-value < 0.05 was considered significant. Results: The comparison of hospital and domiciliary services on the outcome of newborn and mother, showed better services of hospital. Domiciliary care services showed increased number of complications in females during delivery (p-value<0.05) and in newborn (p-value< 0.05) compared to hospital services. Conclusion: Hospital services provide antenatal care by trained person majority of deliveries were normal, while in cases of domiciliary-based services majority faced complications during pregnancy and delivery. Awareness of community is important step to improve mother and child health. Keywords: Antenatal Care; Domiciliary Service; Hospital Services.

scholarly journals Hypertension and Diabetes as a risk factor for dementia: a cross sectional study

2019 ◽  
Vol 7 (9) ◽  
pp. 3337
Author(s):  
Arshad Yahya ◽  
Robina Shamim ◽  
Kuljeet S. Anand
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Vascular Dementia ◽  
Statistical Tests ◽  
Positive Association ◽  
Cross Sectional Study ◽  
World Health ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional

Background: A relation between possible cardiovascular risk factors (hypertension and diabetes) and dementia has been studied in the past and an association has been documented, in spite of some studies pointing to the contrary. Our purpose is to analyze the relation between these risk factors and dementia and add some information to the existing concept and will try to conceptualize the pathogenesis of dementia.Methods: This was a cross sectional study. Patients were recruited from amongst those presenting to our department by convenient consecutive sampling method after taking consent. Five hundred patients of different types of dementia were enrolled. Hypertension was diagnosed using JNC7 criteria. World health organization (WHO) diagnostic criteria were used to diagnose diabetes mellitus. The open Epi software version 3 was used to find the absolute values after preparing 2×2 table. Continuous quantitative data were analyzed using chi square test. Odds ratio and Risk ratio were also calculated. For all statistical tests, a p Value less than 0.05 was taken to indicate significance.Results: Study provides the strong positive association of hypertension (HTN) and diabetes mellitus (DM) with vascular dementia (VaD) but the relationship of these risk factors were not positively correlated with other dementia. Conclusions: Positive association of these risk factors with vascular dementia were found but not with the other types of dementia.

scholarly journals Syndromic approach to identify cases of vaginal discharge: a cross-sectional study among females of Shaheed Nagar, Bhopal, Madhya Pradesh

2018 ◽  
Vol 6 (1) ◽  
pp. 412
Author(s):  
Nisha Singh ◽  
Seema Patel ◽  
Anshuli Trivedi ◽  
Yogendra Chouhan
Keyword(s):  
Health Care Providers ◽  
Vaginal Discharge ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
P Value ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Diagnosis ◽  
Syndromic Approach

Background: Management of Sexually Transmitted Infections (STIs) is important in controlling STIs and to break the chain of infection and transmission.Syndromic case management is a standardized evidence-based approach which utilizes clinical management algorithms and flowcharts that are handy and can be consistently used across health care providers. The objectives of the study were to identify cases of vaginal discharge in Shaheed Nagar, Bhopal and to provide them treatment following syndromic approach.Methods: Prospective cross-sectional study carried out over a period of three months among reproductive age group females (15-45 years) in Shaheed Nagar, Bhopal. Purposive sampling by conducting door- to- door survey until 150 women fulfilling study criteria was interviewed. A pre-designed questionnaire used for data collection. Educational intervention given to all participants. 37 participants identified with vaginal discharge syndrome and were assisted by study team to gynecological OPD for obtaining treatment based on syndromic approach. Data entered in MS Excel 2007 and statistical analysis carried out using epi-info 7.2. Proportions and percentages were calculated. Chi-square was used to find out association between prevalence of vaginal discharge and qualitative variables. P value <0.05 considered statistically significant.Results: Prevalence of vaginal discharge was 24.67%. The most common presenting complaint was general weakness (52%). The most common diagnosis was cervicitis (8.67%) followed by vaginitis (4.67%). Statistically significant correlation was found between presence of disease (STI) and use of intra- uterine device (IUD), non-use of sanitary pads, marital status, occupation and socio- economic class.Conclusions: Abnormal vaginal discharge can both be the cause as well as the effect of pelvic inflammatory disease. 

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 Perceived disrespect and abuse among women delivering at a tertiary care center in Nepal

2021 ◽  
Author(s):  
Sabika Munikar ◽  
Mala Chalise ◽  
Ranjan Dhungana ◽  
Durga Laxmi Shrestha ◽  
Naresh Pratap KC ◽  
...  
Keyword(s):  
Maternity Care ◽  
Care Center ◽  
Tertiary Care ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Monthly Income ◽  
Multinomial Regression ◽  
Cross Sectional ◽  
Free Care ◽  
Type Of Delivery

AbstractBackgroundOf the children born every year in Nepal, 57.4% are delivered in health facilities. Disrespect and abuse of women during maternity care are problems that can significantly impact women’s willingness to seek out life-saving maternity care. However, evidence suggests ongoing disrespectful maternity care worldwide. This study aims to identify perceived disrespect and abuse during labor and delivery among postnatal women delivering at Bheri Hospital, Nepal.MethodsA cross sectional study was conducted among 445 purposively selected women admitted in postnatal ward of Bheri Hospital, Nepal from February to March 2020. Ethical approval was obtained from Nepal Health Research Council. Informed written consent was obtained from each participant and a face-to-face interview was conducted for data collection. A semi-structured questionnaire consisting of demographic information and a pre-validated Respectful Maternity Care (RMC) tool was used. The information was then checked, coded, and entered in SPSS for descriptive and inferential analysis.ResultsIn this study, the participants perceived very high friendly care, abuse-free care and discrimination-free care but moderate timely care only. Timely care was found to be significantly associated with age, ethnicity, occupation, monthly income, gravida, type of delivery, and complications. On multinomial regression, monthly income and type of delivery were the only factors found to be significant. Those mothers who had spontaneous vaginal delivery were 2.07 times more likely to have neutral RMC, and those who earn less than twenty thousand Nepalese rupees per month were likely to perceive high timely RMC.ConclusionThis study concludes that disrespectful or abusive maternal care is not perceived among women delivering at Bheri Hospital in terms of friendly care, abuse-free care and non- discriminatory care. However, timely care is less reported. Appropriate interventions to provide timely care to delivering women must be instituted.

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