Respectful maternity care in Ethiopian public health facilities
Abstract Background Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatmen...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | Reproductive Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12978-017-0323-4 |
| _version_ | 1818975034641743872 |
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| author | Ephrem D. Sheferaw Eva Bazant Hannah Gibson Hone B. Fenta Firew Ayalew Tsigereda B. Belay Maria M. Worku Aelaf E. Kebebu Sintayehu A. Woldie Young-Mi Kim T. van den Akker Jelle Stekelenburg |
| author_facet | Ephrem D. Sheferaw Eva Bazant Hannah Gibson Hone B. Fenta Firew Ayalew Tsigereda B. Belay Maria M. Worku Aelaf E. Kebebu Sintayehu A. Woldie Young-Mi Kim T. van den Akker Jelle Stekelenburg |
| author_sort | Ephrem D. Sheferaw |
| collection | DOAJ |
| description | Abstract Background Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatment of women in hospitals and health centers, and identifies factors associated with occurrence of RMC and mistreatment of women during institutional labor and childbirth services. Methods This study had a cross sectional study design. Trained external observers assessed care provided to 240 women in 28 health centers and hospitals during labor and childbirth using structured observation checklists. The outcome variable, providers’ RMC performance, was measured by nine behavioral descriptors. The outcome, any mistreatment, was measured by four items related to mistreatment of women: physical abuse, verbal abuse, absence of privacy during examination and abandonment. We present percentages of the nine RMC indicators, mean score of providers’ RMC performance and the adjusted multilevel model regression coefficients to determine the association with a quality improvement program and other facility and provider characteristics. Results Women on average received 5.9 (66%) of the nine recommended RMC practices. Health centers demonstrated higher RMC performance than hospitals. At least one form of mistreatment of women was committed in 36% of the observations (38% in health centers and 32% in hospitals). Higher likelihood of performing high level of RMC was found among male vs. female providers ( β ^ = 0.65 $$ \widehat{\beta}=0.65 $$ , p = 0.012), midwives vs. other cadres ( β ^ = 0.88 $$ \widehat{\beta} = 0.88 $$ , p = 0.002), facilities implementing a quality improvement approach, Standards-based Management and Recognition (SBM-R©) ( β ^ = 1.31 $$ \widehat{\beta}=1.31 $$ , p = 0.003), and among laboring women accompanied by a companion β ^ = 0.99 $$ \widehat{\beta} = 0.99 $$ , p = 0.003). No factor was associated with observed mistreatment of women. Conclusion Quality improvement using SBM-R© and having a companion during labor and delivery were associated with RMC. Policy makers need to consider the role of quality improvement approaches and accommodating companions in promoting RMC. More research is needed to identify the reason for superior RMC performance of male providers over female providers and midwives compared to other professional cadre, as are longitudinal studies of quality improvement on RMC and mistreatment of women during labor and childbirth services in public health facilities. |
| first_indexed | 2024-12-20T15:49:32Z |
| format | Article |
| id | doaj.art-760fa49d41ff49829d6e7b05c3da1c5d |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-12-20T15:49:32Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-760fa49d41ff49829d6e7b05c3da1c5d2022-12-21T19:34:45ZengBMCReproductive Health1742-47552017-05-0114111210.1186/s12978-017-0323-4Respectful maternity care in Ethiopian public health facilitiesEphrem D. Sheferaw0Eva Bazant1Hannah Gibson2Hone B. Fenta3Firew Ayalew4Tsigereda B. Belay5Maria M. Worku6Aelaf E. Kebebu7Sintayehu A. Woldie8Young-Mi Kim9T. van den Akker10Jelle Stekelenburg11JhpiegoJhpiegoJhpiegoEthiopian Midwives AssociationJhpiegoJhpiegoJhpiegoJhpiegoMinistry of HealthJhpiegoDepartment of Obstetrics, Leiden University Medical CenterLeeuwarden Medical CentreAbstract Background Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatment of women in hospitals and health centers, and identifies factors associated with occurrence of RMC and mistreatment of women during institutional labor and childbirth services. Methods This study had a cross sectional study design. Trained external observers assessed care provided to 240 women in 28 health centers and hospitals during labor and childbirth using structured observation checklists. The outcome variable, providers’ RMC performance, was measured by nine behavioral descriptors. The outcome, any mistreatment, was measured by four items related to mistreatment of women: physical abuse, verbal abuse, absence of privacy during examination and abandonment. We present percentages of the nine RMC indicators, mean score of providers’ RMC performance and the adjusted multilevel model regression coefficients to determine the association with a quality improvement program and other facility and provider characteristics. Results Women on average received 5.9 (66%) of the nine recommended RMC practices. Health centers demonstrated higher RMC performance than hospitals. At least one form of mistreatment of women was committed in 36% of the observations (38% in health centers and 32% in hospitals). Higher likelihood of performing high level of RMC was found among male vs. female providers ( β ^ = 0.65 $$ \widehat{\beta}=0.65 $$ , p = 0.012), midwives vs. other cadres ( β ^ = 0.88 $$ \widehat{\beta} = 0.88 $$ , p = 0.002), facilities implementing a quality improvement approach, Standards-based Management and Recognition (SBM-R©) ( β ^ = 1.31 $$ \widehat{\beta}=1.31 $$ , p = 0.003), and among laboring women accompanied by a companion β ^ = 0.99 $$ \widehat{\beta} = 0.99 $$ , p = 0.003). No factor was associated with observed mistreatment of women. Conclusion Quality improvement using SBM-R© and having a companion during labor and delivery were associated with RMC. Policy makers need to consider the role of quality improvement approaches and accommodating companions in promoting RMC. More research is needed to identify the reason for superior RMC performance of male providers over female providers and midwives compared to other professional cadre, as are longitudinal studies of quality improvement on RMC and mistreatment of women during labor and childbirth services in public health facilities.http://link.springer.com/article/10.1186/s12978-017-0323-4Respectful maternity careMistreatment of womenLabor and deliveryBirth companionBirth positioningEthiopia |
| spellingShingle | Ephrem D. Sheferaw Eva Bazant Hannah Gibson Hone B. Fenta Firew Ayalew Tsigereda B. Belay Maria M. Worku Aelaf E. Kebebu Sintayehu A. Woldie Young-Mi Kim T. van den Akker Jelle Stekelenburg Respectful maternity care in Ethiopian public health facilities Reproductive Health Respectful maternity care Mistreatment of women Labor and delivery Birth companion Birth positioning Ethiopia |
| title | Respectful maternity care in Ethiopian public health facilities |
| title_full | Respectful maternity care in Ethiopian public health facilities |
| title_fullStr | Respectful maternity care in Ethiopian public health facilities |
| title_full_unstemmed | Respectful maternity care in Ethiopian public health facilities |
| title_short | Respectful maternity care in Ethiopian public health facilities |
| title_sort | respectful maternity care in ethiopian public health facilities |
| topic | Respectful maternity care Mistreatment of women Labor and delivery Birth companion Birth positioning Ethiopia |
| url | http://link.springer.com/article/10.1186/s12978-017-0323-4 |
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