Abstract
BackgroundFacility-based childbirth has increased globally. Unfortunately, there have also been reports of women experiencing disrespect and abuse by healthcare providers during childbirth. This study aimed to measure the prevalence of self-reported disrespect and abuse (D&A) by healthcare providers of women during childbirth in health facilities in Tanzania, and to clarify the factors related to D&A.MethodsA cross-sectional survey was conducted in public health facilities of three regions in Tanzania from September 2016 to October 2016. Nurses and midwives who had ever conducted deliveries completed a 22-item section about D&A and three sections about working conditions and environment. A model for predicting D&A based on several factors such as their characteristics, working conditions, and working environment was developed by conducting multiple regression analysis.ResultsThirty public health facilities in three regions within Tanzania were selected to reflect different levels of hospitals. Among 456 participants (nurses, midwives, and nursing assistants), 439 were included in the analysis. Average number of self-reported D&A out of 22 items was five, and nearly all participants (96.1%) reported enacting one form of D&A at the least and two forms of D&A at the most. About 25–44% of D&A items were in the forms related to women’s experiences with childbirth psychologically. Moreover, at least 10–30% of the participants enacted some form of D&A which could directly affect the well-being of mothers and babies. D&A scores increased with an increase in ‘working hours per week’ and ‘taking a break during evening shifts’. D&A scores decreased with an increase in the scores of the ‘two components of the Index of Working Satisfaction (professional status and interaction between nurses)’, and ‘any type of supervision for new nurse-midwives’.ConclusionMost studies about D&A of healthcare providers previously focused on the reports of women. To our knowledge, this is the first report that focused on D&A reported by healthcare providers. Working conditions and systems including personal relationships with colleagues were both positively and negatively related to D&A of healthcare providers rather than the provider’s individual and facility structural characteristics.
Highlights
IntroductionNational strategies to improve maternal and newborn health have been given much attention in areas such as health coverage or quantity of resources, the quality dimension has received less attention over the last decade [3]
Working conditions and systems as factors related to disrespect and abuse (D&A) Our study showed that heavy workload, poor relation with co-workers, pride of their own job and lack of supervision were related to D&A behaviors of nurses and midwives, as found in previous studies [16, 37, 41, 42]
Conclusion most nurses and midwives who participated in this study in Tanzania reported enacting at least one or two forms of D&A during childbirth
Summary
National strategies to improve maternal and newborn health have been given much attention in areas such as health coverage or quantity of resources, the quality dimension has received less attention over the last decade [3]. In this context, the quality of facility-based care during childbirth has become an important subject of discussion among maternal and child health policy makers [4, 5]. These good care and childbirth experiences may encompass respect for women’s basic human rights [10,11,12]
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