Abstract
High maternal and newborn mortality is a pressing problem in developing countries. Poor treatment during childbirth contributes directly and indirectly to this problem. Many women experience disrespectful and abusive treatment during childbirth worldwide which violates their rights. In Kenya, 20% of women report having experienced some form of disrespect and abuse (D&A). Bungoma County is among the 15 counties with the worst maternal and newborn health statistics in Kenya. The maternal mortality rate is 382 per 100,000 live births and newborn deaths 32 per 1,000 live births, while skilled birth attendance is 41.4%. This study was motivated by the poor maternal and newborn indicators, rising incidences of D&A, limited formal research on respectful maternity care. The study aimed at assessing women’s experience of care during childbirth at Level 5 health facilities in Bungoma County. The specific objectives were to determine the women’s experiences of care during childbirth, to determine factors contributing to disrespect and abuse during childbirth and to identify strategies for addressing issues affecting respectful maternity care for promoting quality of maternal and newborn care. A cross-sectional descriptive study design was used. It involved 360 mothers. Analysis of quantitative data was done using SPSS. Descriptive statistics were presented in graphs, tables, frequencies and percentages. Qualitative data was analysed thematically. The prevalence of D&A was 42.2%, younger age and lower education aggravated D&A. Autonomy, privacy and confidentiality, and absence of birth companionship were major aspects of D&A. Health workforce shortage, inadequate supervision, space and beds, poor provider-patient relationships were factors leading to D&A. It was concluded that there is a need for increased incorporation of Respectful Maternity Care (RMC) in routine care, deploy more staff, avail equipment and supplies, and enhance support supervision. The study information intends to assist stakeholders in prioritising policy actions for improving the quality of maternal and newborn health outcomes and indicators.
Highlights
High maternal and newborn mortality and morbidity remains a pressing problem in developing countries (Furuta et al, 2014)
This study found out that communication barrier between the women and provider or not giving adequate information, shortage of healthcare providers, inadequate training and support supervision, and women sharing beds alongside their newborns, which curtailed their privacy and exposed them to nosocomial infections were some of the factors leading to disrespect and abuse
The current study found out that transport was not a barrier to accessing a health facility in Bungoma County, as suggested by Gabrysch et al (2009)
Summary
High maternal and newborn mortality and morbidity remains a pressing problem in developing countries (Furuta et al, 2014). Maternity care interventions are related to pregnancy, childbirth, and the postpartum period aimed at improving maternal and newborn health outcomes. They include monitoring the health and wellbeing of the mother and baby, health education, and assistance during childbirth. Its components entail Respectful Maternity Care (RMC); Emergency Obstetric and Newborn Care (EmONC); Essential Newborn Care (ENC); Focused Antenatal Care (FANC); and Malaria in Pregnancy (MIP) (Wiegers, 2009). This study focused on Respectful Maternity care in promoting quality as a component of maternity care. Respectful Maternity Care is a crucial component of quality of care, it is a human right (WHO, 2018)
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