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Yohannes E, Moti G, Gelan G, Creedy DK, Gabriel L, Hastie C. Impact of disrespectful maternity care on childbirth complications: a multicentre cross-sectional study in Ethiopia. BMC Pregnancy Childbirth 2024; 24:380. [PMID: 38773395 PMCID: PMC11110437 DOI: 10.1186/s12884-024-06574-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Globally, disrespectful, and abusive childbirth practices negatively impact women's health, create barriers to accessing health facilities, and contribute to poor birth experiences and adverse outcomes for both mothers and newborns. However, the degree to which disrespectful maternity care is associated with complications during childbirth is poorly understood, particularly in Ethiopia. AIM To determine the extent to which disrespectful maternity care is associated with maternal and neonatal-related complications in central Ethiopia. METHODS A multicentre cross-sectional study was conducted in the West Shewa Zone of Oromia, Ethiopia. The sample size was determined using the single population proportion formula. Participants (n = 440) were selected with a simple random sampling technique using computer-generated random numbers. Data were collected through face-to-face interviews with a pretested questionnaire and were entered into Epidata and subsequently exported to STATA version 17 for the final analysis. Analyses included descriptive statistics and binary logistic regression, with a 95% confidence interval (CI) and an odds ratio (OR) of 0.05. Co-founders were controlled by adjusting for maternal sociodemographic characteristics. The primary exposure was disrespectful maternity care; the main outcomes were maternal and neonatal-related complications. RESULTS Disrespectful maternity care was reported by 344 women (78.2%) [95% CI: 74-82]. Complications were recorded in one-third of mothers (33.4%) and neonates (30%). Disrespectful maternity care was significantly associated with maternal (AOR = 2.22, 95% CI: 1.29, 3.8) and neonatal-related complications (AOR = 2.78, 95% CI: 1.54, 5.04). CONCLUSION The World Health Organization advocates respectful maternal care during facility-based childbirth to improve the quality of care and outcomes. However, the findings of this study indicated high mistreatment and abuse during childbirth in central Ethiopia and a significant association between such mistreatment and the occurrence of both maternal and neonatal complications during childbirth. Therefore, healthcare professionals ought to prioritise respectful maternity care to achieve improved birth outcomes and alleviate mistreatment and abuse within the healthcare sector.
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Affiliation(s)
- Ephrem Yohannes
- School of Nursing and Midwifery, Griffith University, University Drive, Gold Coast, QLD, 4131, Australia.
- Midwifery Department, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia.
| | - Gonfa Moti
- Surgery Department, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia
| | - Gemechu Gelan
- Midwifery Department, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University, University Drive, Gold Coast, QLD, 4131, Australia
| | - Laura Gabriel
- School of Nursing and Midwifery, Griffith University, University Drive, Gold Coast, QLD, 4131, Australia
| | - Carolyn Hastie
- School of Nursing and Midwifery, Griffith University, University Drive, Gold Coast, QLD, 4131, Australia
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Begna O, Gemede HF, Motuma A, Shibiru T, Tilahun T, Bobo FT, Fite MB. Willingness to join community-based health insurance and its associated factors among households in Nekemte City, Ethiopia. A community-based cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:71. [PMID: 38769540 PMCID: PMC11106978 DOI: 10.1186/s41043-024-00553-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 04/27/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, the prevalence of household willingness to join the community-based health insurance (CBHI) program and its associated factors are less explored in urban area. Therefore, this study was aimed to assess the prevalence of willingness to join community-based health insurance program and its associated factors among households in Nekemte City, Ethiopia. METHODS A community-based cross-sectional study was conducted on 422 randomly selected households in Nekemte City, Ethiopia. Bivariate and multivariable analyses were performed to see the association between the independent and outcome variables using binary logistic regression model. Association was described using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value < 0.05 was considered the cut-off point for declaring a significant. RESULTS Among 422 study participants, 320 (75.83%) [95% CI = 71.5-79.8%)] of the households were willing to join community-based health insurance program. The willingness to join for community-based health insurance was 3.11 times more likely among households who were in the richest quintile (AOR = 3.11; 95% CI = 1.08-8.93), 3.4 times more likely among those who were merchants (AOR = 3.40;1.33, 8.69), 2.52 times more likely among those who had history of chronic illness in the household (AOR = 2.52; 95% CI = 1.43-4.45), 4.09 times more likely among those who had the awareness about the scheme (AOR = 4.09; 95% CI = 1.97-8.47) and 3.29 times more likely among those who had the experience of borrow for medical care (AOR = 3.29; 95% CI = 1.48-7.30). CONCLUSION Nearly three fourth of the households were willing to join community-based health insurance program, however, about one fourth of households were not willing, which is a significant public health problem. Being merchant, having awareness about the scheme, being in the richest wealth quintile, having experience of borrowing for medical care, and having history of chronic illness in the household were factors found to be significantly associated with willingness to join community based health insurance in the study area. Therefore, strengthening awareness creation at community level about the benefit package and principle of the program would increase their demand for the community-based health insurance scheme.
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Affiliation(s)
- Olkeba Begna
- Oromia regional health bureau, Addis Abeba, Ethiopia
| | - Habtamu Fekadu Gemede
- Department of Food Technology and Nutrition, Wollega University, P.O. Box 395, Nekemte, Ethiopia
| | - Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Shibiru
- School of medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Temesgen Tilahun
- School of medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Firew Tekle Bobo
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
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Kajjoune I, de Brouwere V, Manoussi A, Elomrani S, Assarag B. L'expérience de l'accouchement en milieu surveillé dans la province d'Essaouira au Maroc: Quelle réalité? Sex Reprod Health Matters 2023; 31:2272712. [PMID: 38088854 PMCID: PMC11078118 DOI: 10.1080/26410397.2023.2272712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
RésuméUne expérience positive de l'accouchement (EPA) est fondamentale pour des soins maternels de qualité. Toutefois, de nombreuses femmes subissent des comportements non respectueux lors de ce moment crucial. Au Maroc, peu d'études ont mesuré cette expérience, et les éléments l'influençant demeurent insuffisamment documentés. Nous avons conduit une recherche mixte dans la province d'Essaouira entre avril et décembre 2021. Notre enquête, basée sur un questionnaire, a sollicité l'avis de 240 femmes issues de huit centres de santé choisis au hasard. Par ailleurs, des entretiens semi-directifs ont été conduits avec 20 femmes, 47 professionnels de santé et quatre responsables administratifs. Les données quantitatives ont été soumises à des analyses descriptives, bi- et multivariées, tandis que les entretiens ont été analysés selon une approche de contenu thématique. Les données révèlent que 59.2% des participantes ont eu une expérience défavorable lors de leur dernier accouchement. Parmi elles, la majorité a déploré des soins non consentis (86.7%), un manque de respect de leur intimité (45.4%) et des abus verbaux (25%). L'EPA était principalement associée à la qualité de l'environnement de l'accouchement, au soutien pour l'allaitement, à la propreté des installations, au type d'établissement (privé) et à l'absence de complications médicales pendant le travail. Les entretiens ont révélé que le manque de motivation des professionnels de santé, l'absence de formation continue appropriée et des lacunes organisationnelles et managériales ont affecté l'EPA. Notre étude souligne le besoin crucial de formation continue axée sur le respect des patients, l'éthique et la déontologie, et met en lumière l'importance d'une politique motivante pour les professionnels de santé, notamment dans le secteur public.
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Affiliation(s)
- Imane Kajjoune
- Lauréate, École Nationale de Santé Publique, Rabat, Maroc. Correspondence:
- Chef du Service du réseau des Etablissements de Santé à la Délégation Provinciale de Rhamna, Ministère de la Santé et de la Protection Sociale, Rabat, Morocco
| | - Vincent de Brouwere
- Professeur émérite, Institute of Tropical Medicine, Antwerp, Belgium
- Professeur associé, École Internationale de Santé Publique, Université Mohamed VI des Sciences de la Santé, Casablanca, Maroc
- Visitng Professor, School of Tropical Medicine & Global Health, University of Nagasaki, Nagasaki, Japon
| | - Abdelmounaim Manoussi
- Doctorant, Université Cadi Ayyad, Faculté des sciences Semlalia, Département de biologie, Marrakech, Maroc
| | - Sanae Elomrani
- Doctorante, École Nationale de Santé Publique, Rabat, Maroc
| | - Bouchra Assarag
- Chercheure en DSSR, Directrice Adjoint chargée des études, École Nationale de Santé Publique, Rabat, Maroc
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Kawish AB, Umer MF, Arshed M, Khan SA, Hafeez A, Waqar S. Respectful Maternal Care Experience in Low- and Middle-Income Countries: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1842. [PMID: 37893560 PMCID: PMC10608623 DOI: 10.3390/medicina59101842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/19/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Respectful maternity care promotes practices that acknowledge women's preferences and women and newborns' needs. It is an individual-centered strategy founded on ethical and human rights principles. The objective of this systematic review is to identify the impact of income on maternal care and respectful maternity care in low- and middle-income countries. Materials and Methods: Data were searched from Google Scholar, PubMed, Web of Science, NCBI, CINAHL, National Library of Medicine, ResearchGate, MEDLINE, EMBASE database, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Maternity and Infant Care database. This review followed PRISMA guidelines. The initial search for publications comparing low- and middle-income countries with respectful maternity care yielded 6000 papers, from which 700 were selected. The review articles were further analyzed to ensure they were pertinent to the comparative impact of income on maternal care. A total of 24 articles were included, with preference given to those published from 2010 to 2023 during the last fourteen years. Results: Considering this study's findings, respectful maternity care is a crucial component of high-quality care and human rights. It can be estimated that there is a direct association between income and maternity care in LMICs, and maternity care is substandard compared to high-income countries. Moreover, it is determined that the evidence for medical tools that can enhance respectful maternity care is sparse. Conclusions: This review highlights the significance of improving maternal care experiences, emphasizing the importance of promoting respectful practices and addressing disparities in low- and middle-income countries.
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Affiliation(s)
- Ayesha Babar Kawish
- Alshifa School of Public Health, AlShifa Trust, Rawalpindi 46200, Pakistan; (A.B.K.); (S.W.)
| | - Muhammad Farooq Umer
- Department of Preventive Dental Sciences, College of Dentistry, King Faisal University, Hofuf 31982, Saudi Arabia
| | - Muhammad Arshed
- University Institute of Public Health, Faculty of Allied Health Sciences, University of Lahore, Near Bhuptian Chowk, Lahore 54590, Pakistan;
| | - Shahzad Ali Khan
- Office of the Vice Chancellor, Health Services Academy University, Chak Shahzad, Islamabad 44000, Pakistan;
| | - Assad Hafeez
- Country Representative World Health Organization (WHO), Salmiya 20001, Kuwait;
| | - Saman Waqar
- Alshifa School of Public Health, AlShifa Trust, Rawalpindi 46200, Pakistan; (A.B.K.); (S.W.)
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Batram-Zantvoort S, Wandschneider L, Razum O, Miani C. A critical review: developing a birth integrity framework for epidemiological studies through meta-ethnography. BMC Womens Health 2023; 23:530. [PMID: 37817176 PMCID: PMC10565979 DOI: 10.1186/s12905-023-02670-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
Over the past decade, there has been growing evidence that women worldwide experience sub-standard care during facility-based childbirth. With this critical review, we synthesize concepts and measurement approaches used to assess maternity care conditions and provision, birth experiences and perceptions in epidemiological, quantitative research studies (e.g., obstetric violence, maternal satisfaction, disrespect or mistreatment during childbirth, person-centered care), aiming to propose an umbrella concept and framework under which the existing and future research strands can be situated. On the 82 studies included, we conduct a meta-ethnography (ME) using reciprocal translation, in-line argumentation, and higher-level synthesis to propose the birth integrity multilevel framework. We perform ME steps for the conceptual level and the measurement level. At the conceptual level, we organize the studies according to the similarity of approaches into clusters and derive key concepts (definitions). Then, we 'translate' the clusters into one another by elaborating each approach's specific angle and pointing out the affinities and differences between the clusters. Finally, we present an in-line argumentation that prepares ground for the synthesis. At the measurement level, we identify themes from items through content analysis, then organize themes into 14 categories and subthemes. Finally, we synthesize our result to the six-field, macro-to-micro level birth integrity framework that helps to analytically distinguish between the interwoven contributing factors that influence the birth situation as such and the integrity of those giving birth. The framework can guide survey development, interviews, or interventional studies.
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Affiliation(s)
- Stephanie Batram-Zantvoort
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.
| | - Lisa Wandschneider
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Céline Miani
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
- Sexual and Reproductive Health and Rights Research Unit, Institut National d'Études Démographiques (Ined), Aubervilliers, France
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Awad A, Shalash A, Abu-Rmeileh NME. Women's experiences throughout the birthing process in health facilities in Arab countries: a systematic review. Reprod Health 2022; 19:68. [PMID: 35303901 PMCID: PMC8931971 DOI: 10.1186/s12978-022-01377-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mistreatment of women during facility-based childbirth has become a significant public health issue globally and is gaining worldwide attention. This systematic review of quantitative studies aimed to estimate the prevalence of mistreatment women may experience throughout the birthing process in health facilities in Arab countries. The review also aimed to identify the types of mistreatment, terminology, tools, and methods used to address this topic. METHODOLOGY The search was conducted using three electronic databases: "PubMed," "Embase," and "CINAHL" in May 2020. Studies meeting the inclusion criteria were included and assessed for risk of bias. The analysis was conducted based on the evidence-based typology developed by Bohren et al. as a guide to try to estimate the prevalence of mistreatment. RESULTS Eleven studies out of 174 were included. The included studies belonged to only seven Arab countries out of 22 Arab countries. The mistreatment of women during childbirth is still new in the region. Searching within the included studies yielded diverse and indirect terms that were a proxy for the word mistreatment. These terms were not comprehensive to cover different aspects of the topic. The tools that were used to measure the terms widely varied.. Moreover, it was not possible to estimate the prevalence of mistreatment of women due to high heterogeneity among the 11 studies. CONCLUSION The topic of mistreatment of women in Arab countries was not adequately addressed in the studies included in this review. More research on this topic is recommended due to its importance in improving maternal health in the region. However, a standardized and comprehensive terminology for mistreatment of women, a standardized tool, and a standardized methodology are recommended to enable comparability between results and allow pooling to estimate the prevalence.
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Affiliation(s)
- Arein Awad
- Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine
| | - Aisha Shalash
- Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine.,School of Medicine, University of Limerick, Limerick, Ireland
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine.
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Nigusie A, Endehabtu BF, Angaw DA, Teklu A, Mekonnen ZA, Feletto M, Assan A, Samuel A, Sheikh K, Tilahun B. Status of Compassionate, Respectful, and Caring Health Service Delivery: Scoping Review. JMIR Hum Factors 2022; 9:e30804. [PMID: 35129450 PMCID: PMC8863364 DOI: 10.2196/30804] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/03/2021] [Accepted: 10/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background A compassionate, respectful, and caring (CRC) health professional is very important for human-centered care, serving clients ethically and with respect, adhering to the professional oath, and serving as a model for young professionals. As countries try to achieve universal health coverage (UHC), quality delivery of health services is crucial. CRC health care is an initiative around the need to provide quality care services to clients and patients. However, there is an evidence gap on the status of CRC health care service delivery. Objective This scoping review aimed to map global evidence on the status of CRC health service delivery practice. Methods An exhaustive literature review and Delphi technique were used to answer the 2 research questions: “What is the current status of CRC health care practices among health workers?” and “Is it possible for health professionals, health managers, administrators, and policy makers to incorporate it into their activity while designing strategies that could improve the humanistic and holistic approach to health care provision?” The studies were searched from the year 2014 to September 2020 using electronic databases such as MEDLINE (PubMed), Cochrane Library, Web of Science, Hinari, and the World Health Organization (WHO) library. Additionally, grey literature such as Google, Google Scholar, and WorldWideScience were scrutinized. Studies that applied any study design and data collection and analysis methods related to CRC care were included. Two authors extracted the data and compared the results. Discrepancies were resolved by discussion, or the third reviewer made the decision. Findings from the existing literature were presented using thematic analysis. Results A total of 1193 potentially relevant studies were generated from the initial search, and 20 studies were included in the final review. From this review, we identified 5 thematic areas: the status of CRC implementation, facilitators for CRC health care service delivery, barriers to CRC health care delivery, disrespectful and abusive care encountered by patients, and perspectives on CRC. The findings of this review indicated that improving the mechanisms for monitoring health facilities, improving accountability, and becoming aware of the consequences of maltreatment within facilities are critical steps to improving health care delivery practices. Conclusions This scoping review identified that there is limited CRC service provision. Lack of training, patient flow volume, and bed shortages were found to be the main contributors of CRC health care delivery. Therefore, the health care system should consider the components of CRC in health care delivery during in-service training, pre-service training, monitoring and evaluation, community engagement, workload division, and performance appraisal.
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Affiliation(s)
- Adane Nigusie
- Department of Health Education and Behavioural Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu F Endehabtu
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Alemayehu Teklu
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Zeleke Abebaw Mekonnen
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Marta Feletto
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Abraham Assan
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Assegid Samuel
- Human Resources Administration Directorate, Ministry of Health, Addis Ababa, Ethiopia
| | - Kabir Sheikh
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kebede AA, Taye BT, Wondie KY, Tiguh AE, Eriku GA, Mihret MS. Adherence to respectful maternity care guidelines during COVID-19 pandemic and associated factors among healthcare providers working at hospitals in northwest Ethiopia: A multicenter, observational study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100830. [PMID: 34545344 PMCID: PMC8443386 DOI: 10.1016/j.cegh.2021.100830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/23/2021] [Accepted: 07/05/2021] [Indexed: 12/02/2022] Open
Abstract
Background Respectful maternity care is one of the facilitators of women's access to maternity healthcare services. However, it has been evidenced that maternal healthcare services are compromised during the pandemic of coronavirus disease 19 (COVID-19). Moreover, there was a dearth of evidence on healthcare provider's adherence to respectful maternity care guidelines through direct observation. Hence, this study intended to assess healthcare provider's adherence to respectful maternity care guidelines during COVID-19 in northwest Ethiopia. Methods A multicenter observational cross-sectional study was conducted at hospitals in northwest Ethiopia from November 15th/2020 to March 10th/2021. A simple random sampling technique was employed to select 406 healthcare providers. Data were collected through face-to-face interviews and direct observation using a structured questionnaire and standardized checklist respectively. The data were entered into Epi Info 7.1.2 and exported to SPSS version 25 for analysis. A binary logistic regression model was fitted. Both bivariable and multivariable logistic regression analyses were undertaken. The level of significance was claimed based on the adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a p-value of ≤0.05. Results The proportion of healthcare providers adhering to respectful maternity care guidelines during COVID-19 was 63.8% (95% CI: 59.1, 68.4). Job satisfaction (AOR = 1.82; 95% CI: 1.04, 3.18), professional work experience of 3–5 years (AOR = 2.84; 95% CI: 1.74, 4.6) and ≥6 years (AOR = 2.21; 95% CI: 1.11, 4.38), and having education parallel to work (AOR = 0.33; 95% CI: 0.21, 0.51) have an independent statistical significant association with adherence to respectful maternity care guidelines. Conclusion In this study, six out of ten healthcare providers had good adherence to respectful maternity care guidelines. Ensuring health worker's job satisfaction and providing education opportunities by the government would improve healthcare provider's adherence to respectful maternity care standards.
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Affiliation(s)
- Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhan Tsegaw Taye
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kindu Yinges Wondie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agumas Eskezia Tiguh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Azeze Eriku
- Department of Physiotherapy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Adinew YM, Hall H, Marshall A, Kelly J. Disrespect and abuse during facility-based childbirth in central Ethiopia. Glob Health Action 2021; 14:1923327. [PMID: 34402769 PMCID: PMC8382021 DOI: 10.1080/16549716.2021.1923327] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Respectful maternity care is a fundamental human right, and an important component of quality maternity care. Objective The aim of this study was to quantify the frequency and categories of D&A and identify factors associated with reporting D&A among women in north Showa zone of Ethiopia. Method A cross-sectional study was conducted with 435 randomly selected women who had given birth at public health facility within the previous 12 months in North Showa zone of Ethiopia. A digital (tablet-based) structured and researcher administered tool was used for data collection. Frequencies of D&A items organised around the Bowser and Hill categories of D&A and presented in the White Ribbon Alliance’s Universal Rights of Childbearing Women Framework were calculated. 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 odds ratio 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 Hospital birth showed consistent association with all forms of disrespect and abuse. Expanding the size and skill mix of professionals in the hospitals, sensitizing providers consequences of disrespect and abuse could promote dignified and respectful care.
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Affiliation(s)
- Yohannes Mehretie Adinew
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia.,College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Helen Hall
- Monash Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Amy Marshall
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
| | - Janet Kelly
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
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Disrespect and Abuse during Childbirth in Ethiopia: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8186070. [PMID: 33150181 PMCID: PMC7603554 DOI: 10.1155/2020/8186070] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/20/2020] [Accepted: 10/03/2020] [Indexed: 11/22/2022]
Abstract
Background Disrespect and abuse are recognized for the restricting impact of women from seeking maternal care, psychological humiliations, grievances, and unspoken sufferings on women during childbirth. Individual primary studies are limited in explaining of extent of disrespect and abusive care. Hence, this review considers the synthesis of comprehensive evidence on the extent, contributing factors, and consequences of disrespectful and abusive intrapartum care from the women's and providers' perspectives in Ethiopia. Methods Articles had been systematically searched from the databases of PubMed, Cochrane Library, POPLINE, Google Scholar, HINARI, African Journals Online, and WHO Global Health Library. A qualitative and quantitative synthesis was performed using the Bowser and Hill landscape analytical framework. Result Twenty-two studies comprised of the 16 quantitative; 5 qualitative and one mixed studies were included. The most repeatedly dishonored right during facility-based childbirth in Ethiopia was nondignified care, and the least commonly reported abuse was detention in health facilities. These behaviors were contributed by normalization of care, lack of empowerment and education of women, weak health system, and lack of training of providers. Women subjected to disrespectful and abusive behavior distanced themselves from the use of facility-based childbirth-related services and have endured psychological humiliations. Conclusion Disrespectful and abusive care of women during childbirth is repeatedly practiced care in Ethiopia. This result specifically described the contributing factors and their effects as a barrier to the utilization of facility-based childbirth. Therefore, to overcome this alarming problem, health systems and care providers must be responsive to the specific needs of women during childbirth, and implementing policies for standard care of respectful maternity care must be compulsory. In addition, observational, qualitative, and mixed types of studies are required to provide comprehensive evidences on disrespect and abusive behavior during childbirth in Ethiopia.
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Mihret H, Atnafu A, Gebremedhin T, Dellie E. Reducing Disrespect and Abuse of Women During Antenatal Care and Delivery Services at Injibara General Hospital, Northwest Ethiopia: A Pre-Post Interventional Study. Int J Womens Health 2020; 12:835-847. [PMID: 33116933 PMCID: PMC7568622 DOI: 10.2147/ijwh.s273468] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Disrespect and abuse during pregnancy and childbirth continue to be a barrier for the utilization and quality of care in maternal health services. This study was therefore aimed at reducing the disrespect and abuse of mothers during antenatal care and delivery services at Injibara general hospital, northwest Ethiopia. Materials and Methods A pre–post interventional mixed method design was conducted among a total of 738 randomly selected mothers who attended antenatal care and delivery services from November 1, 2018 to May 20, 2019. To collect the data, exit interview using an interviewer-administered structured questionnaire was used. Provision of training, preparation of standard written guidelines and protocols, waiting room construction, availing screening or curtain, equipment, essential drugs and supplies, supportive supervision and mentoring, and staff motivation were the lists of interventions applied to decrease disrespect and abuse. Descriptive statistics and independent t-test were computed. The independanet t-test is used because the study populations at the baseline and endline were different. A p-value of <0.05 and a mean difference with 95% CI was used to test the significance of the interventions. Results The study revealed that disrespect and abuse during pregnancy and childbirth decreased from 71.8% at baseline to 15.9% at the end-line with a 55.9% change (mean difference: 0.56, 95% CI: 0.55–0.57). Alongside, the magnitude on the subscales of disrespect and abuse (physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination and neglected care) was decreased at post-intervention, compared with the baseline. Conclusion Respectful maternal healthcare after the intervention was significantly improved. The finding suggests that provision of training to healthcare providers, written policies and procedures that describe the responsibilities of healthcare providers in the respectful maternal care process, improving facility infrastructure, availing supplies, regular supportive supervision and mentoring and motivation of high-performance employees have the potential to enhance respectful maternal care. Therefore, incorporating such training into pre-service curricula and in‐service training of healthcare workers may indorse the practice of respectful maternal care.
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Affiliation(s)
- Habtamu Mihret
- Injibara General Hospital, Awi Zone administration, Amhara National Regional State, Injibara, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaye Gebremedhin
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Dellie
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kassa ZY, Tsegaye B, Abeje A. Disrespect and abuse of women during the process of childbirth at health facilities in sub-Saharan Africa: a systematic review and meta-analysis. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:23. [PMID: 32894127 PMCID: PMC7487593 DOI: 10.1186/s12914-020-00242-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 08/31/2020] [Indexed: 12/30/2022]
Abstract
Background Disrespectful and abusive treatment of women by health care providers during the process of childbirth at health facility is an international problem. There is a lack of data on disrespect and abuse of women during the process of childbirth at health facilities in Sub-Saharan Africa. The purpose of this study was to determine the prevalence of disrespect and abuse of women during the process of childbirth at health facilities in sub-Saharan Africa. Methods The PRISMA guideline protocol was followed to write the systematic review and meta-analysis. Published studies were searched from Medline, PubMed, CINAHL, EMBASE, Maternal and infant care, science direct, and PsycINFO. Articles were accessed by three reviewers (ZY, BT and AA) using the following key terms, “attitude of health personnel” AND “delivery obstetrics*/nursing” OR “maternity care” AND “disrespect” OR “abuse” OR “professional misconduct” AND “parturition” AND “prevalence” AND “professional-patient relations” AND “Sub-Saharan Africa”. Additional articles were retrieved by cross referencing of reference. The heterogeneity of studies were weighed using Cochran’s Q test and I2 test statistics. Publication bias was assessed by Egger’s test. Results Thirty three studies met the inclusion and included in this systematic review and meta–analysis of disrespect and abuse of women during the process of childbirth at health facilities. The pooled prevalence of disrespect and abuse women during the process of childbirth at health facilities in Sub-Saharan Africa was 44.09% (95% CI: 29.94–58.24).Particularly physical abuse was 15.77% (95% CI: 13.38–18.15), non-confidential care was 16.87% (95% CI: 14.49–19.24), abandonment was 16.86% (95% CI: 13.88–19.84) and detention was 4.81% (95% CI: 3.96–5.67). Conclusion In this study disrespect and abuse of women during the process of childbirth at health facilities are high compared with other studies, particularly non-confidential care and abandonment his high compared with other studies. This study points out that the ministry of health, health care providers, maternal health experts shall due attention to women’s right during the process of childbirth at health facilities.
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Affiliation(s)
- Zemenu Yohannes Kassa
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
| | - Berhan Tsegaye
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Abebaw Abeje
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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