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Fors M, Falcón K, Brandao T, López M, Mena-Tudela D. Investigating Obstetric Violence in Ecuador: A Cross-Sectional Study Spanning the Last Several Years. Healthcare (Basel) 2024; 12:1480. [PMID: 39120183 PMCID: PMC11311404 DOI: 10.3390/healthcare12151480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/01/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
This pilot cross-sectional study was designed to determine the profile of obstetric violence in Ecuador in recent years. An online survey was conducted between March 2022 and April 2022, including women over 18 years who granted their informed consent to participate (n = 1598). We used non-probabilistic sampling to obtain our sample. Fisher's exact test was performed to assess the association between violence and type of birth, healthcare facility, and education level. Out of the women who participated in the study, 89.2% (n = 1426) identified themselves as Mestiza. Additionally, 88.3% (n = 1411) had completed university-level education. The majority of the participants, specifically 63.6% (n = 1017), received their care in public institutions, and 98.2% (n = 1569) reported structural negligence, while 74.5% (n = 1190) reported violation of their right to information. The entire sample affirmed to have experienced violation of the right of presence. This report shows that obstetric violence is present in Ecuador in different ways and that women experience negligence and violation of their right to receive ethical healthcare during childbirth.
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Affiliation(s)
- Martha Fors
- Medical School, Universidad de Las Américas, Quito 170503, Ecuador
| | - Kirsten Falcón
- Facultad de Ciencias Médicas, Universidad de Las Américas, Quito 170503, Ecuador;
| | - Thais Brandao
- Departamento de Psicología, Universidad de Las Américas, Quito 170503, Ecuador;
| | - Maria López
- Departamento de Enfermería, Universidad de Las Américas, Quito 170503, Ecuador;
| | - Desirée Mena-Tudela
- Departamento de Enfermería, Universidad Jaume I, 12006 Castelló de la Plana, Spain;
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Otsin MNA, Oduro GY. Women at crossroads: a qualitative study of induced abortion and violence in a Ghanaian region. CULTURE, HEALTH & SEXUALITY 2024:1-13. [PMID: 38943562 DOI: 10.1080/13691058.2024.2370422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/17/2024] [Indexed: 07/01/2024]
Abstract
Unsafe abortions contribute significantly to maternal mortality and morbidity in Ghana. To reduce this, in 1982 abortion laws in Ghana underwent reform to broaden the conditions under which abortion is accessed. Although, evidence in other contexts highlights the contribution of violence to women's experience of unwanted pregnancy and abortion, such evidence is limited within the Ghanaian abortion literature. This study aims to fill that gap. Informed by phenomenology, interviews were conducted with 10 women who had experienced various forms of violence leading to unwanted pregnancy and unsafe abortions. Participants were recruited between June 2017 and March 2018 in the Ashanti region of Ghana where they sought hospital care for unsafe abortion related complications. Participants mentioned intimate partners as the main perpetrators of violence. Financial challenges were also identified as important in increasing women's vulnerability to violence. Verbal abuse from health workers contributed to denying women access to safe abortion. This paper advances dialogue about the ways in which women's experience of violence from intimate/non-intimate partners and healthcare workers impacts their overall abortion experience. It advocates the empowerment of women to enable them to leave violent relationships, and the retraining of health workers to enable them to adopt respectful and empathetic care practices.
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Affiliation(s)
- Mercy Nana Akua Otsin
- Judith Lumley Centre for Mother, Infant and Family Health Research, La Trobe University, Melbourne, Australia
| | - Georgina Yaa Oduro
- Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Ghana
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Yalley AA, Jarašiūnaitė-Fedosejeva G, Kömürcü-Akik B, de Abreu L. Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality. Front Public Health 2024; 12:1388858. [PMID: 38979044 PMCID: PMC11228167 DOI: 10.3389/fpubh.2024.1388858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Background The mistreatment and abuse of women during childbirth have been recognized as a major global health challenge, impeding facility-based delivery and contributing to the high maternal mortalities globally. The World Health Organization has specifically called for interventions to deal with obstetric violence. This scoping review consolidates the existing literature on interventions aimed at reducing obstetric violence and synthesizes existing knowledge on their impact in promoting respectful maternity care. Methodology Thirteen electronic databases were searched for relevant articles from January 2001 to March 2023. A total of 863 records were identified, and 72 full-text articles were retrieved for further screening. The review includes 16 studies, particularly from low- and middle-income countries, with interventions implemented at medical facilities and involving both women and healthcare providers. Eight of the studies were quantitative, three were qualitative and five used a mixed-methods approach. Findings The results reveal a promising trend in reducing obstetric violence through various interventions. Ten different types of interventions were identified, highlighting strategies to improve the quality of maternity care and enhance patient-centered care. Improved patient-provider communication skills, increased privacy measures, and reduced abuse and mistreatment emerged as common themes. Enhanced communication skills, including open discussions and the right to be informed, were crucial in reducing obstetric violence. Privacy measures, such as separate rooms, curtains, and birth companions effectively decreased incidents of non-confidential care. General abuse and mistreatment, including physical abuse and neglect, were also reduced, leading to improved perceptions of respectful care during childbirth. Conclusion Overall, the interventions had a favorable impact on obstetric violence reduction and women's childbirth experiences. However, despite promising results, obstetric violence remains prevalent worldwide, necessitating more efforts to implement effective interventions. To the best of our knowledge, this is the first scoping review on obstetric violence interventions, providing a comprehensive overview of the state of the art. We suggest that further research is needed to explore new interventions, particularly gender-sensitive interventions, to contribute to a growing body of knowledge on the prevention of obstetric violence.
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Affiliation(s)
- Abena Asefuaba Yalley
- Zukunftskolleg, University of Konstanz, Konstanz, Germany
- Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | | | | | - Liliana de Abreu
- Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
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Atuesinya Azusong E, Teye-Kwadjo E, Asante KO. Effect of childbirth experience on the psychological well-being of postpartum women in Accra, Ghana. J Reprod Infant Psychol 2024:1-22. [PMID: 38511351 DOI: 10.1080/02646838.2024.2329721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Women's experience of childbirth can affect their mental health outcomes, many years after the delivery. Consequently, the World Health Organisation has provided recommendations to ensure women receive positive birth experiences during intrapartum care. Yet, negative childbirth experience is widespread in Ghana. This study examined the association between women's childbirth experience (i.e. own capacity, professional support, perceived safety, and participation) and their psychological well-being, and whether or not perceived social support and resilience moderate the childbirth experience - psychological well-being relationship. METHODS Mothers (N = 117) who had given birth in the past month and were receiving postnatal care at two health facilities in the Greater Accra Region of Ghana provided the data for the current analysis. Data were collected using the Childbirth Experience Questionnaire, WHO-5 Well-Being Index, Multidimensional Scale of Perceived Social Support, and Brief Resilience Scale. Hierarchical Linear Regression was used to analyse the data. RESULTS Results showed that childbirth experience domains of own capacity and perceived safety were significantly, and positively associated with psychological well-being. The domains of professional support and participation were not associated with psychological well-being in this sample. Perceived social support and resilience did not moderate the association between childbirth experience and psychological well-being. CONCLUSION The results suggest that efforts by birth practitioners (i.e. midwives, obstetricians, and gynaecologists) to give Ghanaian women positive childbirth experiences through the encouragement of personal control over the birthing process as well as ensuring the safety of the birthing procedure and environment would provide women with optimal mental health outcomes.
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Affiliation(s)
| | - Enoch Teye-Kwadjo
- Department of Psychology, University of Ghana, Accra, Ghana
- Department of Industrial Psychology, Stellenbosch University, Matieland, South Africa
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
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Cavolo A, Pizzolato D. Ethical reflections on organizing the first human trial of artificial womb technologies. Prenat Diagn 2024; 44:336-342. [PMID: 38204186 DOI: 10.1002/pd.6521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To investigate how to protect participants in the artificial womb technology (AWT) human trials. METHOD We compared randomized controlled trials and single arm trials to understand which trial design best balances the interests of science and participants. We also compared AWT trials with comparable settings to understand how to protect participants. RESULTS Randomized trials might fail in reaching a sizeable sample, which could pointlessly expose participants to risks. Furthermore, parents who choose to participate in the trial might expect to receive AWT. Failed expectations might distress parents and hinder the therapeutic relationship. The trial is divided into two steps. First, delivery into AWT involves two participants: the mother and the fetus. As AWT requires a C-section, the procedure cannot be carried out without the mother's consent regardless of fetal benefit. Treatment in AWT, involves one participant: the infant. As for any other invasive intervention, the AWT trial should be suspended if harmful. CONCLUSIONS A single arm trial could prevent some of the methodological and ethical challenges of the randomized trials. Moreover, better decisional tools should be developed to help parents decide whether to participate in the AWT trial. For example, using visual aids or showing the AWT.
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Affiliation(s)
- Alice Cavolo
- Institute of Biomedical Ethics and History of Medicine (IBME), University of Zurich, Zurich, Switzerland
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | - Daniel Pizzolato
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
- European Network of Research Ethics Committees, Bonn, Germany
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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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Yalley AK, Ahiatrogah S, Yalley AB, Yankson IK, Nii-Trebi NI, Yalley AA. Did Ghana Do Enough? A Scientometric Analysis of COVID-19 Research Output from Ghana within the African Context. Diseases 2023; 11:diseases11020056. [PMID: 37092438 PMCID: PMC10123632 DOI: 10.3390/diseases11020056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
The COVID-19 pandemic has generated worldwide research efforts to provide knowledge about the disease. Yet little is known about how Ghana contributed to this critical knowledge production. This scientometric analysis was conducted to ascertain Ghana’s COVID-19 research output within the African context to gain understanding and identify potential future directions. The study retrieved relevant research, spanning 2019 to 2022, from the Scopus database in December 2022. The retrieved data were assessed using various established indices, including collaboration patterns, productive institutions, citation patterns, and major research sponsors, among others. Ghana came seventh in Africa with a total of 1112 publications. For international collaborations, the United States and the United Kingdom were the major partners, while South Africa was the main African collaborator with Ghana. Out of the top 21 most productive authors, 85.7% were males and 14.3% were females, demonstrating a great gender gap in research output in Ghana. Although Ghana has made some contributions to the global COVID-19 research output, there are few intra-continental research collaborations, which limits Africa’s overall research output. Our study demonstrates a critical need for the Ghanaian government to prioritize research and funding and address barriers to women’s research productivity.
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Affiliation(s)
- Akua K. Yalley
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu, Accra P.O. Box 143, Ghana
| | - Selasie Ahiatrogah
- Department of Obstetrics and Gynaecology, College of Medicine, Pan African University of Life and Earth Sciences Institute, University of Ibadan, Ibadan P.O. Box 22133, Nigeria
| | - Akuba B. Yalley
- Department of Mining Engineering, University of Mines and Technology, Tarkwa P.O. Box 237, Ghana
| | - Isaac K. Yankson
- CSIR-Building and Road Research Institute, Kumasi P.O. Box UP40, KNUST, Ghana
| | - Nicholas I. Nii-Trebi
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu, Accra P.O. Box 143, Ghana
| | - Abena Asefuaba Yalley
- Zukunftskolleg, Department of Politics and Public Administration, University of Konstanz, 78464 Konstanz, Germany
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