Abstract
BackgroundEvery woman is entitled to respectful care during childbirth; so it is concerning to hear of informal reports of mistreatment during childbirth in Guinea. This study sought to explore the perceptions and experiences of mistreatment during childbirth, from the perspectives of women and service providers, and the analysis presents findings according to a typology of mistreatment during childbirth.MethodsThis study used qualitative methods (in-depth interviews (IDIs) and focus group discussions (FGDs)) and was conducted with four groups of participants: women of reproductive age, midwives, doctors, and administrators. The study took place in two sites in Guinea, an urban area (Mamou) and peri-urban (Pita). Data collection was conducted in two health facilities for providers and administrators, and in the health facility catchment area for women. Data were collected in local languages (Pular and Malinké), then transcribed and analyzed in French. We used a thematic analysis approach and coded transcripts manually.ResultsA total of 64 IDIs and eight FGDs were conducted and are included in this analysis, including 40 IDIs and eight FGDs with women of reproductive age, 5 IDIs with doctors, 13 IDIs with midwives, and 6 IDIs with administrators. Participants described their own personal experiences, experiences of women in their communities and perceptions regarding mistreatment during childbirth. Results were organized according to a typology of mistreatment during childbirth, and included instances of physical abuse, verbal abuse, abandonment and neglect. Women described being slapped by providers, yelled at for noncompliance with provider requests, giving birth on the floor and without skilled attendance in the health facility. Poor physical conditions of health facilities and health workforce constraints contributed to experiences of mistreatment.ConclusionsThese results are important because they demonstrate that the mistreatment of women during childbirth exists in Guinea and occurs in multiple forms. These data should be used by the Ministry of Health and other stakeholders to develop strategies to reduce and prevent the mistreatment of women during childbirth.
Highlights
Every woman is entitled to respectful care during childbirth; so it is concerning to hear of informal reports of mistreatment during childbirth in Guinea
This study was conducted in two areas of Guinea, and used qualitative methods to explore how women and healthcare providers in Guinea experience and perceive mistreatment during childbirth
Qualitative methods allowed us to hear from the voices of women and healthcare providers themselves, as they shared their own personal experiences, experiences of women in their communities and perceptions regarding mistreatment during childbirth
Summary
Every woman is entitled to respectful care during childbirth; so it is concerning to hear of informal reports of mistreatment during childbirth in Guinea. An estimated 303,000 maternal deaths occurred globally in 2015, with approximately two-thirds occurring in subSaharan Africa [1]. Target 5 aimed to improve maternal health, by reducing the maternal mortality ratio (MMR, maternal deaths per 100,000 live births) by 75 percent by 2015 and achieving universal access to reproductive health services [1]. Key aspects of reducing maternal mortality include increasing skilled birth attendance and childbirth in health facilities that are adequately equipped with trained personnel, physical resources, medical supplies, and can provide emergency obstetric and newborn care [2, 3]. Key challenges remain in Guinea, where limited physical resources exist in the health facilities, medical and drug supply chains are unreliable, health worker shortages exist, and the cost of care can be prohibitively expensive [4, 5]
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