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Shakibazadeh E, Namadian M, Bohren MA, Vogel JP, Rashidian A, Nogueira Pileggi V, Madeira S, Leathersich S, Tunçalp Ӧ, Oladapo OT, Souza JP, Gülmezoglu AM. Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG 2017; 125:932-942. [PMID: 29117644 PMCID: PMC6033006 DOI: 10.1111/1471-0528.15015] [Citation(s) in RCA: 196] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/26/2022]
Abstract
Background What constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable. Objectives To develop a conceptualisation of RMC. Search strategy Key databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies. Selection criteria Primary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date. Data collection and analysis A combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings. Main results Sixty‐seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent. Conclusions This review presents an evidence‐based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programmes. Tweetable abstract Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies. Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies.
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Affiliation(s)
- E Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Namadian
- Social Determinants of Health Research Centre, Zanjan University of Medical Sciences, Zanjan, Iran
| | - M A Bohren
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Vogel
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A Rashidian
- Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - V Nogueira Pileggi
- GLIDE Technical Cooperation and Research, Ribeirão Preto, São Paulo, Brazil.,Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - S Madeira
- Social Department of Ribeirão Preto, Medical School, University of São Paulo, São Paulo, Brazil
| | - S Leathersich
- King Edward Memorial Hospital for Women, Subiaco, WA, Australia
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - O T Oladapo
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Souza
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
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Pileggi VN, Monteiro JP, Margutti AVB, Camelo JS. Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data. Braz J Med Biol Res 2016; 49:S0100-879X2016000300705. [PMID: 26840712 PMCID: PMC4763819 DOI: 10.1590/1414-431x20155012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 09/14/2015] [Indexed: 11/26/2022] Open
Abstract
Malnutrition constitutes a major public health concern worldwide and serves as an
indicator of hospitalized patients’ prognosis. Although various methods with which to
conduct nutritional assessments exist, large hospitals seldom employ them to diagnose
malnutrition. The aim of this study was to understand the prevalence of child
malnutrition at the University Hospital of the Ribeirão Preto Medical School,
University of São, Brazil. A cross-sectional descriptive study was conducted to
compare the nutritional status of 292 hospitalized children with that of a healthy
control group (n=234). Information regarding patients’ weight, height, and
bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained,
and the phase angle was calculated. Using the World Health Organization (WHO)
criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10%
had undernutrition and 19.17% were overweight. Classification according to the
bioelectrical impedance results of nutritional status was more sensitive than the WHO
criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited
undernutrition and 4.20% were overweight. After applying the WHO criteria in the
unpaired control group (n=234), we observed that 100.00% of the subjects were
eutrophic; however, 23.34% of the controls were malnourished according to impedance
analysis. The phase angle was significantly lower in the hospitalized group than in
the control group (P<0.05). Therefore, this study suggests that a protocol to
obtain patients’ weight and height must be followed, and bioimpedance data must be
examined upon hospital admission of all children.
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Affiliation(s)
- V N Pileggi
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J P Monteiro
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A V B Margutti
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J S Camelo
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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