Abuse in South African maternity settings is a disgrace: Potential solutions to the problem

Honikman, Simone; Fawcus, Sue; Meintjes, Ingrid

doi:10.7196/samj.9582

Cited by 43 publications

(39 citation statements)

References 23 publications

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“…Interpersonal quality of care, disrespect and abuse during facility based childbirth has garnered increased attention. Studies from a range of cultural contexts have recently reported care providers' lack of empathy, rudeness, uninformed decision making and denial of care (14,26). Such abusive language and practices violate the basic right of women to be treated with respect for their dignity (9) and can signi cantly impact women's willingness to seek life-saving maternity care (12,14,23).…”

Section: Discussionmentioning

confidence: 99%

‘I would have stayed home if I could manage it alone’; testimony of an Ethiopian mother abandoned by care providers during facility based childbirth: a case report

Adinew

Hall

Marshall

et al. 2020

Preprint

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Background: Every woman is entitled to respectful care during pregnancy and childbirth as a basic human right. However, not all women are being treated equally well. Case presentation: This case study highlights some of the common disrespectful practices that women face. This is a testimony of a 28-year-old mother of two, narrated in her own words. The data were collected during an in-depth interview in November 2019. The interview was conducted in her house and her name has been changed to protect her identity. The interview was audio-taped by a digital voice recorder, later transcribed and translated verbatim from the local language, Amharic, to English.Conclusion: This woman’s story highlights the unfortunate reality for some women. Five themes emerged from her narrative: denial of care, non-consented care, non-dignified care, taking a sick baby home with resentment, and loss of trust of care providers.

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Section: Discussionmentioning

confidence: 99%

‘I would have stayed home if I could manage it alone’; testimony of an Ethiopian mother abandoned by care providers during facility based childbirth: a case report

Adinew

Hall

Marshall

et al. 2020

Preprint

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“…[15][16][17] A number of studies have reported on the disrespectful care and mistreatment that some birthing women experience in South African (SA) public health facilities. [18][19][20][21] We developed CLEVER, a district-level labour ward package, with scale-up in mind. It is based on a stages-of-change framework and conditions for sustaining the intervention are embedded in the design.…”

Section: In Practicementioning

confidence: 99%

Systems thinking: A turning point for improving respectful obstetric care in South African health districts

2018

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Poorly functioning health systems and local health systems barriers affect many women giving birth in low-and middle-income countries. The district clinical specialist teams in South Africa are uniquely positioned to provide facilitation and mentoring during interventions for improving the weak primary healthcare system. To ensure success, four key principles should be considered during scale-up of interventions: systems thinking and awareness of contexts and barriers; a focus on sustainability; harnessing factors known to enhance scalability; and respect for human rights and equity. Asking the right questions about the responsibilities of health systems at the micro-, meso-and macrolevels will benefit scale-up processes and sustain innovative pathways to high-quality obstetric care in communities.

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“…In South Africa, women are expected to bear the suffering of childbirth. Studies in community-based maternity care facilities found that many pregnant women express expectations of being 'shouted at, beaten or neglected" 19 . This inadequate social support accounts for the prevalence of mental health issues.…”

Section: Screening Programmentioning

confidence: 99%

“…This training also has the added benefit of tackling the issue of stigma. In South Africa, there is a documented history of health care workers abusing pregnant women, both physically and emotionally 19 . In response to this situation, the PMHP program developed the "Secret History" training method 19 .…”

Section: Barriers From a Provider Perspectivementioning

confidence: 99%

“…In South Africa, there is a documented history of health care workers abusing pregnant women, both physically and emotionally 19 . In response to this situation, the PMHP program developed the "Secret History" training method 19 . This is a step at improving empathetic engagement style, showing the program's effort in improving long-standing healthcare problems.…”

Section: Barriers From a Provider Perspectivementioning

confidence: 99%

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The Perinatal Mental Health Project: A Critical Appraisal of Program Viability, Accessibility and Sustainability

Cui¹,

Jiang²,

Nie³

2018

Preprint

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Background. Perinatal depression is one of the leading causes of disability in perinatal women and is highly prevalent in disadvantaged communities in LMICs. However, care capacity remains low in most LMICs. As such, we decided to find and assess a screening program that addresses perinatal mental health problems in a resource-efficient manner. This leads us to a critically appraisal of the Perinatal Mental Health Project (PMHP), a screening program based in peri-urban Western Cape Town that stresses task sharing and stepped care intervention. Method. PubMed, Ovid Medline (1946 to 2018), and Google Scholar were searched for publications until March 2018, with data or evaluation of the PMHP. PMHP website publications were used for data and interpretation. The program’s viability was evaluated based on criteria published by UK National Screening Council. The program’s impact was analyzed using published patient outcome data. Access to care was evaluated at three barriers to accessing care proposed by Gjerdingen et al. (2007). The financial model was evaluated using the “four-pillars” of sustainable organization financial management proposed by León (2001). Findings. The PMHP’s screening program viability satisfies most criteria of the UK National Screening Council, and the program’s benefits outweigh its harms. Patient self-reports indicate successful impact with several highlights in accessibility. The program also demonstrates financial sustainability and potential for scaling-up. Interpretations. The operation model of the PMHP shows satisfactory viability and sustainability. With modifications fitting local context and government cooperation, this model offers promising potential in bringing public health and economic benefits.

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Abuse in South African maternity settings is a disgrace: Potential solutions to the problem

Cited by 43 publications

References 23 publications

‘I would have stayed home if I could manage it alone’; testimony of an Ethiopian mother abandoned by care providers during facility based childbirth: a case report

‘I would have stayed home if I could manage it alone’; testimony of an Ethiopian mother abandoned by care providers during facility based childbirth: a case report

Systems thinking: A turning point for improving respectful obstetric care in South African health districts

The Perinatal Mental Health Project: A Critical Appraisal of Program Viability, Accessibility and Sustainability

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