Abstract
BackgroundDisrespect and abuse (D&A) of women during childbirth by the attending staff in health facilities has been widely reported in many countries. Although D&A in labor rooms is recognized as a deterrent to maternal health service utilization, approaches to defining, classifying, and measuring D&A are still at an early stage of development. This study aims to enhance understanding of service providers’ experiences of D&A during facility based childbirth in health facilities in Addis Ababa.MethodsA facility based cross-sectional study was conducted in August 2013 in one hospital and three health centers. A total of 57 health professionals who had assisted with childbirth during the study period completed a self-administered questionnaire. Service providers’ personal observations of mistreatment during childbirth and their perceptions of respectful maternity care (RMC) were assessed. Data were entered into and analyzed using SPSS version 16 software.ResultsThe majority (83.7%) of participants were aged <30 years (mean = 27.25 ± 5.45). Almost half (43.9%) were midwives, and 77.2% had less than five years experience as a health professional. Work load was reported to be very high by 31.6% of participants, and 28% rated their working environment as poor or very poor. Almost half (50.3%) of participants reported that service providers do not generally obtain women’s consent prior to procedures. One-quarter (25.9%) reported having ever witnessed physical abuse (physical force, slapping, or hitting) in their health facility. They also reported observing privacy violations (34.5%), and women being detained against their will (18%). Violations of women’s rights were self-reported by 14.5% of participants. More than half (57.1%) felt that they had been disrespected and abused in their work place. The majority of participants (79.6%) believed that lack of respectful care discourages pregnant women from coming to health facilities for delivery.ConclusionsThe study findings indicate that most service providers from these facilities had witnessed disrespectful practices during childbirth, and recognized that such practices have negative consequences for service utilization. These findings can help decision makers plan for interventions to improve RMC taking account of the provider perspective.
Highlights
Disrespect and abuse (D&A) of women during childbirth by the attending staff in health facilities has been widely reported in many countries
This paper presents findings of a study conducted among health service providers who attend women during childbirth to assess their experiences of disrespectful and abusive practices
Fifty-seven service providers from one hospital and three health centers located in Addis Ababa, Ethiopia, completed a questionnaire
Summary
Disrespect and abuse (D&A) of women during childbirth by the attending staff in health facilities has been widely reported in many countries. The presence of hostile or insensitive staff [7], disallowance of birth companions [7], disrespectful care [12], women’s lack of autonomy [6] and privacy [13], inadequate facilities in labor wards [14], and abuse by staff [14] are among the constellation of factors that actively deter women from attending for facility-based childbirth. These studies all report practices and conditions that characterize what has come to be known as disrespect and abuse (D&A), which discourages women from attending for facility-based deliveries and denies their rights to high quality childbirth services as declared by the United Nations [15, 16]
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