Developing a tool for measuring postpartum women's experiences of respectful maternity care at a tertiary hospital in Kumasi, Ghana

Pascal Agbadi,Adwoa Bemah Boamah Mensah,Veronica Millicent Dzomeku,Jody R Lori,Kweku Emmanuel Nakua,Peter Donkor

doi:10.1016/j.heliyon.2020.e04374

Pascal Agbadi, Adwoa Bemah Boamah Mensah + Show 4 more

Open Access

https://doi.org/10.1016/j.heliyon.2020.e04374

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Abstract

The authors of this paper are involved in a 5 years respectful maternity care (RMC) project at a tertiary healthcare facility in Kumasi, Ghana that seeks to change the culture of disrespect and abuse in maternity care practice, with a sub-objective of determining its impact on how midwives provide quality maternity care services in this healthcare facility. To achieve this objective, respectful maternity care must be conceptualized and measured. Our literature search revealed that a Ghanaian version tool that measures women's experiences of respectful maternity care is non-existent. Thus, this study aims to construct a scale that measures childbearing women's experiences of respectful maternity care during childbirth and the immediate postpartum period in the study setting. We surveyed 263 postpartum women with a draft scale we have developed. This scale had 42 questions that sought to measure postpartum women's experiences of respectful maternity care in a tertiary health facility in Kumasi. The scale development went through processes of exploratory factor analyses (EFA) and inter-item reliability tests. The EFA was done using SPSS-21. Through series of EFA, we have created a 23 items RMC scale (23i-RMC) with three main factors labelled as follows: Verbal abuse-free, Discriminatory-free and Dignified care (VADDC), Physical and Psychological Abuse-free care (PPAC), and Compassionate Care (CC). The Cronbach's Alpha of the 23i-RMC is 0.945 and those of the individual domains greater than the 0.70 minimum threshold, suggesting that there is greater reliability among the items in the scale and the subscales. This 23i-RMC scale is useful for assessing postpartum women's experiences of RMC in the study setting. We recommend the use and validation of the newly developed respectful maternity care scale in other healthcare facilities in Ghana.

Highlights

Along with other effective and efficient policies and programs, many low-and-middle-income countries (LMICs) are reducing their unacceptably high maternal and neonatal death rates through the promotion and implementation of healthcare facility-based deliveries with skilled birth attendants [1, 2, 3, 4, 5]
Women's Physical and Psychological Abuse-free care (PPAC) scores across the level of education are generally low, suggesting that many of the respondents have reported the type of intrapartum care received at the hospital to be physically and psychologically abusive
Postpartum women experiences of respectful maternity care (RMC) at the facility differed based on their educational qualification, with the women with no formal education rating their experiences of RMC on the full scale and two of the subscales (PPAC and Compassionate Care (CC)) at the hospital higher than those with some form of education

Summary

Introduction

Along with other effective and efficient policies and programs, many low-and-middle-income countries (LMICs) are reducing their unacceptably high maternal and neonatal death rates through the promotion and implementation of healthcare facility-based deliveries with skilled birth attendants [1, 2, 3, 4, 5]. Other RMC scales were developed within the context of LMICs [18, 19], with one originating from Ethiopia [19] All these scales are tools for measuring women's experiences of RMC, the subscales and items of the different scales have notable variations in the way certain aspect of the phenomenon were conceptualized. These observed variations were mainly context-specific, making it an important criterion in the design and measuring of RMC within a Ghanaian context

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