Form Of Disrespect Research Articles

Exposure to disrespectful maternity care and perceptions of respectful maternity care among nursing and midwifery pre-registration students in China: A national cross-sectional study

AimsTo 1) determine the prevalence and types of disrespectful maternity care witnessed by students; 2) describe students’ perceptions of respectful maternity care and associated factors; and 3) investigate whether witnessing disrespectful care influences their perceptions of respectful maternity care. BackgroundLimited evidence exists about nursing and midwifery students' perceptions of respectful maternity care and prevalence of disrespectful maternity care in China. Understanding students' perceptions can inform pre-registration curricula and clinical practice programs, promoting the implementation of respectful maternity care. DesignAn exploratory national online survey was conducted. MethodsData were analysed using bivariate analysis and multi-factor analysis of variance. ResultsAmong 733 students, positive perceptions towards respectful maternity care were common. Approximately one-fifth witnessed disrespect, with physical violence, lack of communication and untimely care most frequently reported. A better understanding of respectful maternity care was associated with female students of Han ethnicity, majoring in midwifery, undertaking a longer internship/practicum and reporting fewer instances of observed disrespect.Although students reported positive perceptions of respectful maternity care, inadequate understanding was evident. Incorporating relevant content about respectful care into the curriculum is suggested. Reducing students’ exposure to disrespectful maternity care may ensure that certain forms of disrespect or abuse do not become normalized among students. This requires system-level efforts to create a safe and supportive working environment for maternity health providers. ConclusionTo promote respectful maternity care in China, system-level changes are warranted. Respectful maternity care needs to be essential content in pre-registration midwifery and nursing curricula. Encouraging students to identify poor practice and discuss good practice in a safe learning environment is warranted.

Respectful maternity care during childbirth: Experiences and observation among mothers in a tertiary-care institute in Manipur.

Respectful maternity care (RMC) refers to the humane and dignified treatment of a childbearing woman throughout her pregnancy, childbirth and immediate postpartum period. Disrespect and abuse of women during labour, childbirth and immediate postpartum period in health facilities is one of the reasons which deter them from further utilizing maternal healthcare services. The present study was thus undertaken to determine to what extent RMC practices are being followed in a health facility in Manipur. A cross-sectional study was conducted from May 2022 to August 2022 in a Health facility among women coming for institutional delivery along with direct observations of the labour room. The study tool comprises a semistructured questionnaire related to respectful maternity care which was adapted from the Person-Centered Maternity Care Scale, a validated instrument. The direct observation method was carried out using a checklist adapted from a standardized tool developed by the United States Agency for International Development (USAID). Descriptive statistics were generated and approval of the study was obtained from the Institutional Ethics Committee. A total of 336 (99.1%) women reported at least one form of disrespect or abuse during childbirth. Maximum abuse (91.4%) was reported in the facility and environment domain. Direct observation done on 22 deliveries in the labour room found that 72.7% of the women experienced at least one form of disrespect and abuse. Two (9.1%) women were observed to face physical force or abusive behaviour. Almost all the women reported at least one form of disrespect or abuse during childbirth. There is a need to improve the health facilities and women need to be treated with dignity and respect as it is being violated according to the findings in many studies as with ours.

Forms of disrespect: Toddler's peer conflicts in early childhood education and care

This article discusses the ways in which toddlers carry out forms of disrespect during peer conflicts in Australian and Finnish early childhood education and care (ECEC) settings. We investigate forms of disrespect in naturally occurring peer interactions by applying interaction analysis and Honneth’s theory of recognition. Drawing on Honneth , our study provides an empirical foundation for examining what leads to toddlers’ disrespectful acts. Our analysis shows that, especially outside adults’ view, disrespect in peer conflicts disrupts the fundamental preferences for peer agreement, alignment and affiliation. It threatens the norms of peaceable conduct, and so can be seen as a challenge to the social and moral order. A toddler's struggles for recognition arise from exclusion from play and the violation of the toddler's body. Implications arising from this research highlight the role of adults in identifying different forms of disrespect that occur in peer groups.

Association between disrespect and abuse during labor and the risk of postpartum depression: a cross-sectional study

This study aimed to analyze the relationship between disrespect and abuse during labor and the risk of postpartum depression. This is a cross-sectional study carried out with women from the rural and urban areas of Caxias, Maranhão State, Brazil. Postpartum depression was considered the dependent variable, assessed using the Edinburgh Postnatal Depression Scale. The independent variables were sociodemographic characteristics, mental health history, behavioral aspects, obstetric characteristics and self-perception of disrespect and abuse during labor. Pearson's chi-square test and multiple logistic regression were used to assess the association between postpartum depression and disrespect and abuse during labor. A total of 190 women were interviewed. The prevalence of postpartum depression was 16.3%. The occurrence of at least one type of disrespect and abuse during labor was 97.4%, with health system conditions and restrictions predominating (94.7%). More than half of the women (66.3%) suffered two forms of disrespect and abuse during labor, while three or more forms were reported by 22.6%. Suffering two (adjustedOR = 3.01; 95%CI 1.08-8.33) and three or more forms of disrespect and abuse during labor (adjustedOR = 3.41; 95%CI: 1.68-24.40) increased the chance of postpartum depression. There was a significant association between disrespect and abuse during labor and postpartum depression, and dignified and respectful care for women during childbirth were found to reduce the risk of postpartum depression symptoms.

Blasphemy of Prophet (SAW) Act, An overview of specific Eras and Acts in Pakistan

It is a religious duty for every Muslim to have faith in and abide by the teachings of the final Prophet, honoring him both as a Prophet and as the guiding authority of Islamic principles. Prophet Muhammad (peace be upon him) is held in the highest regard, and his teachings shall be upheld until the Day of Judgment. No one can challenge the noble characteristics and attributes of the Prophet, and any form of disrespect towards him is considered blasphemous. Being the Prophet of Islam, he is an integral part of the foundations of Islamic law. Muslim nations have also enshrined his position as the Prophet, guide, and leader in their constitutions, laws, and regulations. Violating this respect is a breach of the country's laws, and those found guilty of insulting him will face legal consequences. Pakistan has taken measures to ensure that no one challenges the Prophet's status or tolerates any act of insult towards him. Various individuals have worked towards this cause. Within this context, an assessment is being made regarding the Act that deals with instances of blasphemy against Prophet Muhammad (peace be upon him) during specific periods in Pakistan.

Respectful Maternal Care Initiative: Experiences at a Tertiary Care Center in Haryana

Abstract Objective: Respectful Maternity Care (RMC) is a part of the prescribed standard of health care norms globally today. The RMC has been defined under seven broad domains, which are useful in identifying and quantifying maternal disrespect and abuse and dealing with solutions. Evidence on the nature and frequency of maternal disrespect and abuse is essential for effective policy and advocacy. The present study is directed to assess the current status of RMC. Materials and Methods: It was a hospital-based cross-sectional study carried out in a tertiary care center over a period of 3 months. A total of 220 women who delivered at our institute during the data collection period and met inclusion criteria were enrolled for the study. Data were collected using a predesigned and pretested questionnaire based on seven major categories per the respectful maternity care (RMC) charter and included sociodemographic details of respondents. Results: Of all, nearly half of them experienced at least one or theother form of disrespect during their labor, childbirth, or postnatal period at the hospital. The lowest mean scoring was seen in domains of confidential care (3.32), dignified care (3.07), and abuse related to cost of detention (3.38). Conclusion: Although mothers are noticing and reporting positive changes in maternity care practices, respectful maternity care still has miles to go. Effective and sustainable measures need to be implemented within the context of the Indian health system to stop the disrespect and abuse surrounding childbirth!

Tackling disrespect in health care: The relevance of socio-relational equality.

Disrespect in health care often persists despite firm commitments to respectful service provision. This conceptual paper highlights how the ways in which respect and disrespect are characterised can have practical implications for how well disrespect can be tackled. We stress the need to focus explicitly on disrespect (not only respect) and propose that disrespect can usefully be understood as a failure to relate to people as equals. This characterisation is consonant with some accounts of respect but sometimes obscured by a focus on respecting people's autonomy and dignity. Emphasising equality is consistent with connections patients draw between being (dis)respected and (in)equality. It readily accommodates microaggressions as forms of disrespect, helping to understand how and why experiences of disrespect may be unintentional and to explain why even small instances of disrespect are wrong. Our view of disrespect with an emphasis on equality strengthens the demand that health systems take disrespect seriously as a problem of social injustice and tackle it at institutional, not just individual levels. It suggests several strategies for practical action. Emphasising relational equality is not an easy or short-term fix for disrespect, but it signals a direction of travel towards an important improvement ambition.

The association between quality of contraceptive counseling and selection of contraceptive method post-counseling among women in Ethiopia

ObjectivesTo better understand the relationship between high-quality contraceptive counseling and met family planning needs, we examined the association between quality of counseling and selection of a method postvisit among women requesting contraception in Ethiopia. Study designWe used post-counseling survey data from women receiving care in public health centers and nongovernmental clinics in three regions in Ethiopia. Among women whose reason for visit was requesting a contraceptive method, we examined the association between scores on the validated quality of contraceptive counseling (QCC) scale and subscales and selection of a method post-counseling (primary analysis) and type of method selected (secondary analysis). We conducted mixed-effects multivariable logistic regression for the primary analysis and multinomial regression for the secondary analysis. ResultsThere was a nonsignificant increase in odds of selecting contraception with increasing total QCC scale scores (adjusted odds ratio [aOR] 2.35, 0.43–12.95). However, among women experiencing no disrespect and abuse, there was increasing odds of selecting contraception (aOR 3.46, 95% CI 1.09–10.99) and likelihood of selecting injectable contraception (adjusted relative risk ratio 4.27, 95% CI 1.34–13.60) compared to women experiencing disrespect and abuse. Additionally, 168 (32.1%) of women felt pressured by their provider to use a certain method of which>50% selected long-acting reversible contraception. ConclusionsIncreasing QCC is associated with selecting contraception among women requesting contraception. Additionally, probing for negative experiences can reveal feelings of disrespect and abuse that could lead women to avoid selecting contraception or feeling pressured to use methods heavily promoted by providers. ImplicationsOur study assesses contraceptive counseling quality using a validated tool with items on provider pressure and other forms of disrespect and abuse; findings highlight the importance of respectful treatment in meeting women’s needs and the potential influence of disrespect on decision to select contraception and type of method selected.

Notas para un emplumado amanecer: ojos, pasamontañas y corazones en las lecturas ‘deleuzianas’ de Lemebel

From a critical gender perspective, this article offers an analysis of the chronicle that Pedro Lemebel dedicates to Subcomandante Marcos, paying special attention to the Deleuzian dimensions that it incorporates. Dimensions that are not only present in what could be interpreted as a theoretical wink, but also in the practices -visual, oral, written- with which Lemebel seems to overflow and enrich his philosophical origin. If, in general, within the multiple recreations of becoming that are promoted in his chronicles, Lemebel tends to question the symbolic universe of the new man, the text that consecrates Subcomandante Marcos seems to introduce unusual forms of subversion that question and at the same time confront the local revolutionary imaginary. However, it is not only a matter of destabilizing the binarized discourses of the revolution, but also of making visible other possible forms of disrespect and resistance. And that is what seems to be re-created in the memoirs that, in the context of the Chilean revolt of 2019, have taken Lemebel's name from the line of flight to the front line of fire.

A Study to Analyze knowledge regarding respectful maternity care among OBG nurses at Sri Ramakrishna Hospital Coimbatore

Objectives: 1. To identify if any form of disrespect or abuse prevailing during childbirth in Sri Ramakrishna Hospital by nursing staff. 2. To improve our quality of care to promote dignified maternal health services. 3. To achieve Safe motherhood. Methodology: The design was observational design. Target Population was parturient women admitted for delivery. The sample size was 75. Convenient Sampling Technique was used. Observation was evaluated by using analyzing questioners (WHO) National Standards. Quantitative analyses were used in order to interpret the data. The data in turn is interpreted in a bar diagram using scoring system. Result: The study results are Dignity and respect 95%, Communication and autonomy 92%, Supportive care 93%, Privacy and Confidentiality 96% and Facility and environment 95%. Conclusion: Based on the results of this study, direct relationship was observed between respectful maternity care and positive childbirth experience.

Respectful maternity care in health centers of Addis Ababa city: a mixed method study

ObjectiveThe study aims to assess quality of obstetric and newborn care including respectfulness of the maternity care.DesignThe study used explanatory sequential mixed methods design .SettingThis study was conducted in 50 health centres in Addis Ababa city administration January 25 to April 31, 2021.MethodsDuring the quantitative phase 500 women in postpartum period were interviewed using structured questionnaire. In the second phase in-depth interview was conducted with 20 midwives and 13 health centre managers. The quantitative data was analysed using Statistical Package for Social Sciences (SPSS). The qualitative data was analysed using Colaizzi’s seven step process.ResultsOnly 24.6% of women had respectful maternity care (RMC). Only 46% of women had effective communication during child birth. Only 9.6% of women had emotional support during child birth. Majority of women were encouraged to mobilize, take food and be on labor position of their choice. However, only 22.4 and 18.8% of women respectively had a companion of choice and any pharmacologic pain relief during child birth. One in seven women (15%) had one form of disrespect and abuse during child birth.ConclusionEnsuring respectful maternity care needs strong policy direction to health facilities, public education on their right to respectful maternity care, training of care givers and monitoring care through engagement of frontline staff and clients.

Disrespect and abuse experienced by women giving birth in public health facilities of Eastern Ethiopia: a multicenter cross-sectional study.

ObjectiveWe assessed the magnitude of disrespect and abuse experienced by women giving birth at public health facilities in Dire Dawa, Eastern Ethiopia.MethodsWe conducted a facility-based quantitative cross-sectional study in Dire Dawa City Administration from 21 October to 8 December 2020. We used a pre-tested structured questionnaire to interview 555 randomly selected women who gave birth in public health facilities during the study period. Bivariate and multivariate logistic regression analysis was performed in statistical analysis.ResultsAmong 555 women, 473 (85.2%) reported having experienced at least one form of disrespect and abuse. Giving birth at a hospital (adjusted odds ratio [AOR] = 4.15; 95% confidence interval [CI], 2.29–7.51) and being attended by male providers (AOR = 3.27; 95% CI, 1.57–6.81), as well as being attended by three or four providers (AOR = 0.44; 95% CI, 0.22–0.88) and delivering at night (AOR = 0.27; 95% CI, 0.15–0.48) were significantly associated with greater or less likelihood, respectively, of disrespect and abuse.ConclusionWe revealed an unacceptable level of disrespect and abuse toward women giving birth at public health facilities. Health care providers must understand the importance of respectful maternity care. The city's health bureau should conduct provider training and enforce adherence to respectful care.

Status of Respectful Maternity Care Among Women Availing Delivery Services at a Tertiary Care Center in Central India: A Cross-Sectional Study.

IntroductionThere are numerous reports of disrespectful, abusive, or neglectful treatment during childbirth from health facilities worldwide. Although India has substantially increased the number of hospital deliveries and reduced the maternal mortality ratio, the quality of intrapartum and immediate postpartum care for delivering mothers has not been given much importance. Therefore, assessing mistreatment and quality of care during childbirth is vital for promoting respectful maternity care. MethodsA descriptive hospital-based cross-sectional study was carried out in a tertiary care center in central India. A convenience sampling method was used, and a total of 150 consecutive consenting women aged 18-49 years who delivered in the study setting were included. Data was collected using a predesigned and pretested questionnaire based on seven major categories per the Respectful Maternity Care (RMC) Charter.ResultsAll the 150 women in the present study, i.e., 100%, experienced at least one form of disrespect during their labor, childbirth, or postnatal period at the hospital. The mean scores for domains of non-confidential care (0.59), non-consented care (0.95), abandonment or denial of care (1.21), and physical abuse (1.26) are low.ConclusionThe findings of the present study shed important light on the current state of respectful maternity care in the study area. Though mothers are noticing and reporting positive changes in maternity care practices, respectful maternity care still has a long way to go.

Disrespect and abuse during labour and birth amongst 12,239 women in the Netherlands: a national survey

BackgroundWomen experience disrespect and abuse during labour and birth all over the world. While the gravity of many forms of disrespect and abuse is evident, some of its more subtle forms may not always be experienced as upsetting by women. This study examines (1) how often women experience disrespect and abuse during labour and birth in the Netherlands and (2) how frequently they consider such experiences upsetting. We also examine (3) which respondent characteristics (age, ethnicity, educational level and parity) are associated with those experiences of disrespect and abuse that are upsetting, and (4) the associations between upsetting experiences of disrespect and abuse, and women’s labour and birth experiences.MethodsWomen who gave birth up to five years ago were recruited through social media platforms to participate in an online survey. The survey consisted of 37 questions about experiences of disrespect and abuse divided into seven categories, dichotomised in (1) not experienced, or experienced but not considered upsetting (2) experienced and considered upsetting. A multivariable logistic regression analysis was performed to examine associated characteristics with upsetting experiences of disrespect and abuse. A Chi-square test was used to investigate the association between upsetting experiences of disrespect and abuse and overall birth experience.Results13,359 respondents started the questionnaire, of whom 12,239 met the inclusion and exclusion criteria. Disrespect and abuse in terms of ‘lack of choices’ (39.8%) was reported most, followed by ‘lack of communication’ (29.9%), ‘lack of support’ (21.3%) and ‘harsh or rough treatment/physical violence’ (21.1%). Large variation was found in how frequently certain types of disrespect and abuse were considered upsetting, with 36.3% of women experiencing at least one situation of disrespect and abuse as upsetting. Primiparity and a migrant background were risk factors for experiencing upsetting disrespect and abuse in all categories. Experiencing more categories of upsetting disrespect and abuse was found to be associated with a more negative birth experience.ConclusionsDisrespectful and abusive experiences during labour and birth are reported regularly in the Netherlands, and are often (but not always) experienced as upsetting. This emphasizes an urgent need to implement respectful maternity care, even in high income countries.

Midwifery and nursing students’ perceptions of respectful maternity care and witnessing of disrespect and abuse: A comparative study from Nepal and Jordan

ObjectivesTo compare Nepalese and Jordanian midwifery and nursing students’ perceptions of respectful maternity care (RMC) and witnessing of disrespect and abuse; and determine factors that predict scores on a scale measuring perceptions of RMC. DesignA descriptive, comparative design was used. SettingRecruitment took place from two medical colleges in Nepal and one University in Jordan. MethodsA convenience sample of students (n = 276) enrolled in a Bachelor or Diploma level midwifery or nursing degree who were undertaking or had recently completed their midwifery clinical placement were recruited. The online or hard copy survey included the Students’ Perceptions of Respectful Maternity Care (SPRMC) Scale and nine questions on witnessing different types of disrespect and abuse. FindingsNepalese students were slightly older (mean = 23.68 years) than Jordanian students (mean = 21.36). Mean duration of clinical placement was longer for Jordanian students (11.24 compared to 6.28 weeks). However, mean number of births observed was higher among Nepalese students (19.6 compared to 18.62). Overall, perceptions of RMC were more positive among Jordanian students (t (199.97) = 6.68, p < 0.001). A multiple regression analysis found that duration of clinical placement (beta = 0.22, p < 0.001), witnessing disrespect and abuse (beta = 0.11, p = 0.08) and age (beta = -0.14, p = 0.03) explained 12.2% of variance in SPMRC scores. Compared to students in Nepal, all Jordanian students had observed non-consented care during their clinical practicum. However, Nepalese students were more likely to observe poor adherence to women's privacy and confidentiality. Key conclusion and implications for practiceThis is the first study to compare midwifery and nursing students’ perceptions of RMC across two middle-income countries. Although Jordanian students held more positive perceptions of RMC than those in Nepal, more had witnessed different forms of disrespect and abuse. Variations in students’ perceptions of RMC and witnessing of abuse across countries highlight the need for assessment of workplace cultures to inform the development of tailored education and practice interventions for students, clinicians, and managers. Future research needs to explore how to best support students to consistently offer RMC and how to improve the experiences of childbearing women.

Magnitude and pattern of facility-based disrespect and abusive treatment of women during childbirth in Abia State, Nigeria.

To ascertain the prevalence and pattern of reported facility-based disrespect and abuse of women during labour in Abia State, South-East, Nigeria. A cross-sectional questionnaire-based study. One urban and one rural healthcare facility in Abia State- Federal Medical Centre, Umuahia and Nigerian Christian Hospital (NCH) Nlagu, respectively. A total of 312 women who were recently delivered of their babies in the two facilities in Abia State and attending postnatal clinics were sampled for the survey. Disrespect and abuse D&A) during labour among women who give birth in healthcare facilities in Abia State. In all, over half (54.5%) of the women experienced disrespect and abuse in Abia State (50% urban and 63.5% in rural areas). The commonest form of disrespect and abuse was non-confidential care (22.9%). The commonest disrespectful and abusive care received was lack of privacy in the labour ward (18.3%). The study recorded a high prevalence of reported facility-based disrespect and abuse of women during delivery in Abia State. Training and re-training healthcare providers to promote respectful care, advocacy to policy makers and healthcare stakeholders on the development of respectful maternal care policies and further research in the area are needed. No funding was obtained for this study.

Disrespectful Maternity Care and Abuse During Childbirth: Exploring Perceptions and Experiences of Women Delivered at a Tertiary Hospital in Abakaliki, Nigeria.

An important but little understood component of poor care that women receive during antenatal care and childbirth is disrespect and abuse perpetuated by health workers. Fear of experiencing disrespect and abuse has a negative influence on women's decision to seek care at health facility during pregnancy, labour and delivery. The objective of this study is to determine the prevalence, pattern and predictors of disrespect and abuse during labour and delivery. This is a questionnaire-based cross-sectional study conducted from February 1, 2019, to July 31, 2019 among postnatal women delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Data were analyzed using SPSS version 22. The prevalence of disrespectful maternity care and abuse was 47.6%. The forms of disrespect and abuse experienced by the participants were detention in the health facility (40.2%), physical abuse (34.1%), non-dignified care (37.2%), non-consented care (20.1%), abandonment of care (18.9%), non-confidential care (25%) and discriminatory care (15.2%). Lack of companionship during delivery (AOR: 7.01, 95%CI: 1.27-4.49; p = 0.007), unbooked status (AOR: 2.37, 95%Cl: 0.31 - 0.92; p = 0.01) and rural residence (AOR = 4.52 95% CI: 2.33-8.75, P<0.0001) were factors associated with disrespect and abuse during childbirth. Disrespectful maternity care and abuse during childbirth among women seeking maternity care is still prevalent (47.6%) in our hospital. Educating health workers on the importance of respectful maternity care would ensure acceptable, quality and dignified care for all women seeking maternity care in our facility.

Respectful maternal care and by who? perspectives of Somali community at IFO refugee Camp, Dadaab, Kenya

Respectful maternity care is where women are accorded the freedom to make informed choices, protects them from any form of harm and harassment, provides continuous support during labour and child birth and also upholds their privacy, confidentiality and dignity. Previous studies have demonstrated that any care deemed to disrespect the woman may henceforth determine her care seeking behaviour. In the lacuna created by some forms of disrespect of women of child bearing age in the healthcare system, some women may seek alternative care from traditional birth attendants, who are neither skilled nor able to promptly recognize, manage or refer complications arising during pregnancy, labour, child birth and puerperium. Globally, the high maternal mortality rate is associated with preventable complications which occur during pregnancy, labour, child birth and the puerperium, with those who encounter near misses or who narrowly survive death, end up suffering lifelong disability which affects their quality of life. Services offered by traditional birth attendants (TBAs) continue to be sort by a few women of reproductive age in both rural and urban settings including Dadaab, despite the availability of both public and private health facilities. TBAs are preferred among the Somali community as they are deemed to offer a type of care that is regarded as being respectable to the woman and her family as well as being aligned to their culture and religion. Hence, this study aimed to investigate the perspectives of the Somali community residing in Dadaab refugee camps on respectful maternal care. A qualitative study was conducted at Ifo refugee camp in Dadaab, where three TBAs, two save mothers, two married men and two expectant women were interviewed. Two focused group discussions were conducted among the men and pregnant women. The TBAs and the save mothers were interviewed. The TBAs were also video recorded as they performed some of their activities. Data was coded, categorized into thematic areas and the content was analyzed. The findings demonstrated that TBAs and save mothers accorded the women both social and psychological support during pregnancy, child birth, and postnatal period, and treated them with respect. They accompanied the mother throughout the labour and childbirth and gave her so much encouragement. The findings further revealed that cultural beliefs and practices such as prayer, disposal of the placenta and the gender of the care provider, play a big role in maternal care of the women. The placenta is valued as a significant part of the woman’s body and thus has to be buried according to their culture, as opposed to it being disposed of after giving birth in a health facility. Respectful maternal care should be accorded to all women irrespective of their background and should also be culturally sensitive

Assessment of Women’s Experience of Care during Childbirth for Quality Improvement at Level 5 Health Facilities in Bungoma County, Kenya

High maternal and newborn mortality is a pressing problem in developing countries. Poor treatment during childbirth contributes directly and indirectly to this problem. Many women experience disrespectful and abusive treatment during childbirth worldwide which violates their rights. In Kenya, 20% of women report having experienced some form of disrespect and abuse (D&amp;A). Bungoma County is among the 15 counties with the worst maternal and newborn health statistics in Kenya. The maternal mortality rate is 382 per 100,000 live births and newborn deaths 32 per 1,000 live births, while skilled birth attendance is 41.4%. This study was motivated by the poor maternal and newborn indicators, rising incidences of D&amp;A, limited formal research on respectful maternity care. The study aimed at assessing women’s experience of care during childbirth at Level 5 health facilities in Bungoma County. The specific objectives were to determine the women’s experiences of care during childbirth, to determine factors contributing to disrespect and abuse during childbirth and to identify strategies for addressing issues affecting respectful maternity care for promoting quality of maternal and newborn care. A cross-sectional descriptive study design was used. It involved 360 mothers. Analysis of quantitative data was done using SPSS. Descriptive statistics were presented in graphs, tables, frequencies and percentages. Qualitative data was analysed thematically. The prevalence of D&amp;A was 42.2%, younger age and lower education aggravated D&amp;A. Autonomy, privacy and confidentiality, and absence of birth companionship were major aspects of D&amp;A. Health workforce shortage, inadequate supervision, space and beds, poor provider-patient relationships were factors leading to D&amp;A. It was concluded that there is a need for increased incorporation of Respectful Maternity Care (RMC) in routine care, deploy more staff, avail equipment and supplies, and enhance support supervision. The study information intends to assist stakeholders in prioritising policy actions for improving the quality of maternal and newborn health outcomes and indicators.

Respectful Maternity Care Interventions in Promoting Quality at Level 5 Health Facilities in Bungoma County, Kenya

High maternal and newborn mortality is a pressing problem in developing settings. Poor treatment during childbirth contributes directly and indirectly to this problem at 82%. Many women experience disrespectful and abusive treatment during childbirth worldwide which violates their rights. In Kenya 20% of women report to have experienced some form of disrespect and abuse. Bungoma County is among the 15 counties with the worst maternal and newborn health statistics. Maternal mortality rate is 382 per 100,000 live births and newborn deaths 32 per 1,000 live births. Skilled birth attendance is 41.4%. This study was motivated by the poor maternal and newborn indicators, rising incidences of D&amp;A, limited interventional and formal research on respectful maternity care. The study aimed at evaluating maternity care interventions for promoting quality of maternal and newborn care at level 5 health facilities in Bungoma County. Quasi-experimental pre-and-post-comparison study design was used. It involved 71 midwives, 351 mothers and 18 key informants. Sensitization was done using respectful maternity care learning resource package. Analysis was done using statistical package for social sciences (SPSS v. 25.0). Descriptive statistics were presented in graphs, tables, frequencies and percentages. On Inferential statistics, Chi square (X2) was used with 95% confidence interval (CI) to determine associations. P values ≤ 0.05 were considered significant. On statistical testing, Pearson Chi-Square was used to measure relationship between women’s experience of care and their socio-demographic characteristics, Wilcoxon Signed Ranks test to measure association between the women’s experience of care and midwives’ performance and McNemar test to measure the statistical difference before and after the intervention. Qualitative data was analyzed thematically. The baseline prevalence of D&amp;A was 42.2% and 25% post intervention, younger age and lower education aggravated D&amp;A. Autonomy, privacy and confidentiality, absence of birth companionship were major aspects of D&amp;A. Health workforce shortage, inadequate supervision, space and beds, poor provider-patient relationship were factors leading to D&amp;A. Sociodemographic characteristics and experience of D&amp;A- age (X2-26.07, P-0.00), marital status (X2-20.851, P-0.002. Association between self-reported and observation report- privacy and confidentiality (Z- -7.728, P-0.00), communication (Z- -2.132, P-0.033), dignity and respect (Z- -7.599, P-0.00). Correlation Pre-Post intervention- dignity and respect (P-0.002), privacy and confidentiality (P-0.00), communication (P-0.00), autonomy (P- 0.063). Conclusion, incorporate RMC in routine care, deploy more staff, avail equipment and supplies, and enhance support supervision. The study information intends to assist stakeholders in prioritizing policy actions for improving quality of maternal and newborn health outcomes and indicator