An innovative intervention to improve respectful maternity care in three Districts in Ethiopia
Abstract Background Mistreatment of women during facility-based childbirth is a major violation of human rights and often deters women from attending skilled birth. In Ethiopia, mistreatment occurs in up to 49.4% of mothers giving birth in health facilities. This study describes the development, imp...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-03934-y |
| _version_ | 1818908858192494592 |
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| author | Birkety Mengistu Haregeweyni Alemu Munir Kassa Meseret Zelalem Mehiret Abate Befikadu Bitewulign Kedest Mathewos Kendra Njoku Neil S. Prose Hema Magge |
| author_facet | Birkety Mengistu Haregeweyni Alemu Munir Kassa Meseret Zelalem Mehiret Abate Befikadu Bitewulign Kedest Mathewos Kendra Njoku Neil S. Prose Hema Magge |
| author_sort | Birkety Mengistu |
| collection | DOAJ |
| description | Abstract Background Mistreatment of women during facility-based childbirth is a major violation of human rights and often deters women from attending skilled birth. In Ethiopia, mistreatment occurs in up to 49.4% of mothers giving birth in health facilities. This study describes the development, implementation and results of interventions to improve respectful maternity care. As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed respectful maternity care training module with three core components: testimonial videos developed from key themes identified by staff as experiences of mothers, skills-building sessions on communication and onsite coaching. Respectful maternity care training was conducted in February 2017 in three districts within three regions. Methods Facility level solutions applied to enhance the experience of care were documented. Safe Childbirth Checklist data measuring privacy and birth companion offered during labor and childbirth were collected over 27 months from 17 health centers and three hospitals. Interrupted time series and regression analysis were conducted to assess significance of improvement using secondary routinely collected programmatic data. Results Significant improvement in the percentage of births with two elements of respectful maternal care—privacy and birth companionship offered— was noted in one district (with short and long-term regression coefficient of 18 and 27% respectively), while in the other two districts, results were mixed. The short-term regression coefficient in one of the districts was 26% which was not sustained in the long-term while in the other district the long-term coefficient was 77%. Testimonial videos helped providers to see their care from their clients’ perspectives, while quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions. This includes organizing tour to the birthing ward and allowing cultural celebrations. Conclusion This study demonstrated effective way of improving respectful maternity care. Use of a multipronged approach, where the respectful maternity care intervention was embedded in quality improvement approach helped in enhancing respectful maternity care in a comprehensive manner. |
| first_indexed | 2024-12-19T22:17:41Z |
| format | Article |
| id | doaj.art-25abb5207d81488d9b0fdb3c31d27553 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-19T22:17:41Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-25abb5207d81488d9b0fdb3c31d275532022-12-21T20:03:43ZengBMCBMC Pregnancy and Childbirth1471-23932021-08-0121111010.1186/s12884-021-03934-yAn innovative intervention to improve respectful maternity care in three Districts in EthiopiaBirkety Mengistu0Haregeweyni Alemu1Munir Kassa2Meseret Zelalem3Mehiret Abate4Befikadu Bitewulign5Kedest Mathewos6Kendra Njoku7Neil S. Prose8Hema Magge9Institute for Healthcare ImprovementInstitute for Healthcare ImprovementFederal Ministry of HealthFederal Ministry of HealthInstitute for Healthcare ImprovementInstitute for Healthcare ImprovementInstitute for Healthcare ImprovementInstitute for Healthcare ImprovementDuke Global Health InstituteInstitute for Healthcare ImprovementAbstract Background Mistreatment of women during facility-based childbirth is a major violation of human rights and often deters women from attending skilled birth. In Ethiopia, mistreatment occurs in up to 49.4% of mothers giving birth in health facilities. This study describes the development, implementation and results of interventions to improve respectful maternity care. As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed respectful maternity care training module with three core components: testimonial videos developed from key themes identified by staff as experiences of mothers, skills-building sessions on communication and onsite coaching. Respectful maternity care training was conducted in February 2017 in three districts within three regions. Methods Facility level solutions applied to enhance the experience of care were documented. Safe Childbirth Checklist data measuring privacy and birth companion offered during labor and childbirth were collected over 27 months from 17 health centers and three hospitals. Interrupted time series and regression analysis were conducted to assess significance of improvement using secondary routinely collected programmatic data. Results Significant improvement in the percentage of births with two elements of respectful maternal care—privacy and birth companionship offered— was noted in one district (with short and long-term regression coefficient of 18 and 27% respectively), while in the other two districts, results were mixed. The short-term regression coefficient in one of the districts was 26% which was not sustained in the long-term while in the other district the long-term coefficient was 77%. Testimonial videos helped providers to see their care from their clients’ perspectives, while quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions. This includes organizing tour to the birthing ward and allowing cultural celebrations. Conclusion This study demonstrated effective way of improving respectful maternity care. Use of a multipronged approach, where the respectful maternity care intervention was embedded in quality improvement approach helped in enhancing respectful maternity care in a comprehensive manner.https://doi.org/10.1186/s12884-021-03934-yMistreatmentDisrespectAbuseRespectful maternity careQuality improvementChildbirth |
| spellingShingle | Birkety Mengistu Haregeweyni Alemu Munir Kassa Meseret Zelalem Mehiret Abate Befikadu Bitewulign Kedest Mathewos Kendra Njoku Neil S. Prose Hema Magge An innovative intervention to improve respectful maternity care in three Districts in Ethiopia BMC Pregnancy and Childbirth Mistreatment Disrespect Abuse Respectful maternity care Quality improvement Childbirth |
| title | An innovative intervention to improve respectful maternity care in three Districts in Ethiopia |
| title_full | An innovative intervention to improve respectful maternity care in three Districts in Ethiopia |
| title_fullStr | An innovative intervention to improve respectful maternity care in three Districts in Ethiopia |
| title_full_unstemmed | An innovative intervention to improve respectful maternity care in three Districts in Ethiopia |
| title_short | An innovative intervention to improve respectful maternity care in three Districts in Ethiopia |
| title_sort | innovative intervention to improve respectful maternity care in three districts in ethiopia |
| topic | Mistreatment Disrespect Abuse Respectful maternity care Quality improvement Childbirth |
| url | https://doi.org/10.1186/s12884-021-03934-y |
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