Live experience of community health workers on respectful maternity care in rural Odisha, India: a phenomenological study

Abstract

Background: Every woman deserves respectful maternity care, throughout her journey to motherhood. However, disrespectful maternity care is prevalent in various settings. It has an effect on the utilization of services. It can be more explored from the witness of maternity. The aim of this study was to explore the experience of accredited social health activists on respectful maternity care in Odisha, India. Methods: A qualitative exploratory study was conducted among 24 ASHAs with more than two years of experience to gain a deeper understanding of the phenomenon. This study was conducted in three distinct Odisha districts, India. Results: Two main themes emerged: Community health workers’ experiences and perception towards disrespectful care, and Factors contributing to irrational care. Participants explained that verbal abuse was the most common use of health care providers. The consequences of such abusive behavior hinder the effective and efficient performance of their role, especially when it comes to their role in the facility. The study highlighted major gaps in the behavior and attitudes of healthcare providers at the facility level. Conclusions: Despite the lack of knowledge and training related to RMC, ASHAs acknowledged the abusive and disrespectful behavior of health care providers not only towards the child-bearing women but also towards the accompanying person, i.e., ASHA or a member of the family. Such mistreatment often acts as a barrier to the use of public health services, such as the institutional delivery of child-bearing mothers. A need for orientation and training on RCM among healthcare professionals, along with appropriate monitoring of implementation.