A Qualitative Evaluation of the Choice of Traditional Birth Attendants for Maternity Care in 2008 Sierra Leone: Implications for Universal Skilled Attendance at Delivery

Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip S.; Garbrah-Aidoo, Nana; Kanu, Rugiatu; Oulare, Macoura; Shoo, Rumishael; Daoh, Kizito

doi:10.1007/s10995-012-1061-4

Cited by 36 publications

(46 citation statements)

References 10 publications

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“…Previous studies in Africa have demonstrated clearly the relationship between mistreatment and future childbirth in health facilities. 13,27,28 Eliminating all forms of mistreatment and ensuring that women's rights are respected hinges on extensive education, especially in low resource settings, on whether such acts are appropriate or useful. In this study, some women believed that in some contexts, some forms of physical and verbal abuse are needed to ensure the safety of the mother and baby during childbirth.…”

Section: Discussionmentioning

confidence: 99%

Women’s perspectives of mistreatment during childbirth at health facilities in Ghana: findings from a qualitative study

Maya

Adu‐Bonsaffoh

Dako-Gyeke

et al. 2018

Reproductive Health Matters

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Mistreatment of women during childbirth at health facilities violates their human rights and autonomy and may be associated with preventable maternal and newborn mortality and morbidity. In this paper, we explore women's perspectives on mistreatment during facility-based childbirth as part of a bigger World Health Organization (WHO) multi-country study for developing consensus definitions, and validating indicators and tools for measuring the burden of the phenomenon. Focus group discussions (FGDs) and in-depth interviews (IDIs) were used to explore experiences of mistreatment from women who have ever given birth in a health facility in Koforidua and Nsawam, Ghana. Interviews were audio-recorded, transcribed and thematic analysis conducted. A total of 39 IDIs and 10 FGDs involving 110 women in total were conducted. The major types of mistreatment identified were: verbal abuse (shouting, insults, and derogatory remarks), physical abuse (pinching, slapping) and abandonment and lack of support. Mistreatment was commonly experienced during the second stage of labour, especially amongst adolescents. Inability to push well during the second stage, disobedience to instructions from birth attendants, and not bringing prescribed items for childbirth (mama kit) often preceded mistreatment. Most women indicated that slapping and pinching were acceptable means to "correct" disobedient behaviours and encourage pushing. Women may avoid giving birth in health facilities in the future because of their own experiences of mistreatment, or hearing about another woman's experience of mistreatment. Consensus definitions, validated indicators and tools for measuring mistreatment are needed to measure prevalence and identify drivers and potential entry points to minimise the phenomenon and improve respectful care during childbirth.

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Section: Discussionmentioning

confidence: 99%

Women’s perspectives of mistreatment during childbirth at health facilities in Ghana: findings from a qualitative study

Maya

Adu‐Bonsaffoh

Dako-Gyeke

et al. 2018

Reproductive Health Matters

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“…While there are global efforts to increase facility-based childbirth, there are significant barriers in some settings, preventing women from attending facilities, including distance [13, 14], cost [15, 16], and perceived quality of care [15, 17, 18]. More recently, improving quality of care, including women’s experiences of care, has been highlighted as a key component of strategies to further reduce preventable maternal mortality and morbidity [19].…”

Section: Introductionmentioning

confidence: 99%

Mistreatment of women during childbirth in Abuja, Nigeria: a qualitative study on perceptions and experiences of women and healthcare providers

et al. 2017

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BackgroundGlobal efforts have increased facility-based childbirth, but substantial barriers remain in some settings. In Nigeria, women report that poor provider attitudes influence their use of maternal health services. Evidence also suggests that women in Nigeria may experience mistreatment during childbirth; however, there is limited understanding of how and why mistreatment this occurs. This study uses qualitative methods to explore women and providers’ experiences and perceptions of mistreatment during childbirth in two health facilities and catchment areas in Abuja, Nigeria.MethodsIn-depth interviews (IDIs) and focus group discussions (FGDs) were used with a purposive sample of women of reproductive age, midwives, doctors and facility administrators. Instruments were semi-structured discussion guides. Participants were asked about their experiences and perceptions of, and perceived factors influencing mistreatment during childbirth. Thematic analysis was used to synthesize findings into meaningful sub-themes, narrative text and illustrative quotations, which were interpreted within the context of this study and an existing typology of mistreatment during childbirth.ResultsWomen and providers reported experiencing or witnessing physical abuse including slapping, physical restraint to a delivery bed, and detainment in the hospital and verbal abuse, such as shouting and threatening women with physical abuse. Women sometimes overcame tremendous barriers to reach a hospital, only to give birth on the floor, unattended by a provider. Participants identified three main factors contributing to mistreatment: poor provider attitudes, women’s behavior, and health systems constraints.ConclusionsMoving forward, findings from this study must be communicated to key stakeholders at the study facilities. Measurement tools to assess how often mistreatment occurs and in what manner must be developed for monitoring and evaluation. Any intervention to prevent mistreatment will need to be multifaceted, and implementers should consider lessons learned from related interventions, such as increasing audit and feedback including from women, promoting labor companionship and encouraging stress-coping training for providers.

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“…Recent studies conducted in Sierra Leone identified prohibitive costs to be one of the main barriers for women accessing maternal health care and utilising facilities during childbirth [ 15 - 17 ]. In 2010, in response to these findings, the government of Sierra Leone introduced the Free Health Care Initiative (FHCI) for pregnant women, breastfeeding mothers and children under the age of 5 [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Exploration of perceptions and decision-making processes related to childbirth in rural Sierra Leone

Treacy

Sagbakken

2015

BMC Pregnancy Childbirth

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BackgroundMaternal mortality ratio (MMR) remains high in Sierra Leone. Efforts have been made to reduce MMR by increasing the number of women delivering at a health facility through introduction of the Free Health Care Initiative in 2010. Despite this, utilisation remains lower than aimed for, with marked inequalities between rural and urban settings. This study explores the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone.MethodsA qualitative, cross-sectional study employing focus group discussions, in- depth interviews and informal interviews with pregnant women and community members in rural northern Sierra Leone. Data were analysed using systematic text condensation.ResultsData revealed that the decision-making processes are complex and multi-faceted. Decisions regarding the place of delivery and with whom assisting the birth are often made collectively. A normal delivery is seen as one that occurs within the village. Previous experiences, perceptions and expressions of bodily symptoms as well as the interpretation of different risks affect these decisions. The health seeking behaviours were found to be flexible and dynamic, and the final decisions about where to give birth could be governed by unexpected circumstances.ConclusionsDecision-making processes during childbirth in rural Sierra Leone are dynamic and intricate and need to be understood within the broader social context. Future initiatives to improve access and utilisation of safe health services for pregnant women within rural Sierra Leone need to be based on adequate knowledge of women’s preferences, cultural-specific traits, capabilities, perceptions of risk and the constraints in which they may live.

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A Qualitative Evaluation of the Choice of Traditional Birth Attendants for Maternity Care in 2008 Sierra Leone: Implications for Universal Skilled Attendance at Delivery

Cited by 36 publications

References 10 publications

Women’s perspectives of mistreatment during childbirth at health facilities in Ghana: findings from a qualitative study

Women’s perspectives of mistreatment during childbirth at health facilities in Ghana: findings from a qualitative study

Mistreatment of women during childbirth in Abuja, Nigeria: a qualitative study on perceptions and experiences of women and healthcare providers

Exploration of perceptions and decision-making processes related to childbirth in rural Sierra Leone

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