Coverage, associated factors, and impact of companionship during labor: A large‐scale observational study in six hospitals in Nepal

Kc, Ashish; Axelin, Anna; Litorp, Helena; Tinkari, Bhim Singh; Sunny, Avinash K; Gurung, Rejina

doi:10.1111/birt.12471

Cited by 11 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Nepal, like many other settings, caste and ethnicity are key determinants of social hierarchy and access to care [36]. Families from higher castes and relatively advantaged ethnic groups are more likely to receive higher quality of care [34,53], and have more access to facility birth [54,55]. Qualitative data to exploring these differences would be helpful to better understand if findings are related to local normative values and potential issues of stigmatisation, or data collection methods.…”

Section: Discussionmentioning

confidence: 99%

“…Categorical variable groups were made for age, ethnicity, parity and mode of birth. Two groups were identified based on ethnicity/religion: an advantaged group (women identifying as Chettri/ Brahmin and others) and a disadvantaged group (participants identifying as Dalit; Janjati; Madhesi or Muslim) [34,36]. Parity data were combined into three groups (no previous birth, 1 previous birth, and 2+ previous births).…”

Section: Ineffective Communicationmentioning

confidence: 99%

“…EN-BIRTH aimed to test the validity of measurement for selected newborn and maternal indicators for routine facilitybased tracking of coverage and quality of care [32]. Data were collected in collaboration with the Nepal Perinatal Quality Improvement Project (NePeriQIP) [33,34].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

Gurung

Ruysen

Sunny

et al. 2021

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

Background Respectful maternal and newborn care (RMNC) is an important component of high-quality care but progress is impeded by critical measurement gaps for women and newborns. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study was an observational study with mixed methods assessing measurement validity for coverage and quality of maternal and newborn indicators. This paper reports results regarding the measurement of respectful care for women and newborns. Methods At one EN-BIRTH study site in Pokhara, Nepal, we included additional questions during exit-survey interviews with women about their experiences (July 2017–July 2018). The questionnaire was based on seven mistreatment typologies: Physical; Sexual; or Verbal abuse; Stigma/discrimination; Failure to meet professional standards of care; Poor rapport between women and providers; and Health care denied due to inability to pay. We calculated associations between these typologies and potential determinants of health – ethnicity, age, sex, mode of birth – as possible predictors for reporting poor care. Results Among 4296 women interviewed, none reported physical, sexual, or verbal abuse. 15.7% of women were dissatisfied with privacy, and 13.0% of women reported their birth experience did not meet their religious and cultural needs. In descriptive analysis, adjusted odds ratios and multivariate analysis showed primiparous women were less likely to report respectful care (β = 0.23, p-value < 0.0001). Women from Madeshi (a disadvantaged ethnic group) were more likely to report poor care (β = − 0.34; p-value 0.037) than women identifying as Chettri/Brahmin. Women who had caesarean section were less likely to report poor care during childbirth (β = − 0.42; p-value < 0.0001) than women with a vaginal birth. However, babies born by caesarean had a 98% decrease in the odds (aOR = 0.02, 95% CI, 0.01–0.05) of receiving skin-to-skin contact than those with vaginal births. Conclusions Measurement of respectful care at exit interview after hospital birth is challenging, and women generally reported 100% respectful care for themselves and their baby. Specific questions, with stratification by mode of birth, women’s age and ethnicity, are important to identify those mistreated during care and to prioritise action. More research is needed to develop evidence-based measures to track experience of care, including zero separation for the mother-newborn pair, and to improve monitoring.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Ineffective Communicationmentioning

confidence: 99%

See 1 more Smart Citation

Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

Gurung

Ruysen

Sunny

et al. 2021

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

show abstract

“…We were not able to explore in greater depth whether socioeconomic, age, education, employment, marital status or physical ability impacted on experiences of companionship. Previous studies have found that women who are educated, wealthy and employed are more likely to have a companion present [7,49]. We did not specifically delineate women's desire for companionship during labour and/or birth in the labour observations.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Partnership-defined quality approach to companionship during labour and birth in East New Britain, Papua New Guinea: A mixed-methods study

Wilson

Melepia

Suruka

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

Companionship during labour and birth is a critical component of quality maternal and newborn care, resulting in improved care experiences and better birth outcomes. Little is known about the preferences and experiences of companionship in Papua New Guinea (PNG), and how it can be implemented in a culturally appropriate way. The aim of this study was to describe perspectives and experiences of women, their partners and health providers regarding labour and birth companionship, identify enablers and barriers and develop a framework for implementing this intervention in PNG health facilities. A mixed methods study was conducted with five facilities in East New Britain, PNG. Data included 5 facility audits, 30 labour observations and 29 in-depth interviews with women who had recently given birth, partners and maternity care providers. A conceptual framework was developed drawing on existing quality care implementation frameworks. Women and partners wanted companions to be present, whilst health providers had mixed views. Participants described benefits of companionship including encouragement and physical support for women, better communication and advocacy, improved labour outcomes and assistance with workforce issues. Adequate privacy and space constraints were highlighted as key barriers to address. Of the women observed, only 30% of women had a companion present during labour, and 10% had a companion at birth. A conceptual framework was used to highlight the interconnected inputs required at community, facility and provincial health system levels to improve the quality of care. Key elements to address included attitudes towards companionship, the need for education and training and restrictive hospital policies. Supporting women to have their companion of choice present during labour and birth is critical to improving women’s experiences of care and improving the quality of maternal and newborn care. In order to provide companionship during labour and birth in PNG, a complex, intersecting, multi-faceted approach is required.

show abstract

“…But continuous support during childbirth is the most recommended way of expression ( 13 ). Supporting the strategy for the presence of women's companion of choice during labor and delivery is a well-evaluated intervention with concerning respecting women's autonomy and interest and can be the agent for the improvement in the quality of care during labor and child birth ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Desire for Birth Companionship Among Pregnant Women Attending Antenatal Care in Debremarkos City, Northwest Ethiopia: Magnitude and Associated Factors

Assfaw

Abuhay

Asratie

2022

Front. Glob. Womens Health

View full text Add to dashboard Cite

BackgroundBirth companionship is one of the components of the respectful maternity continuum of care recommended by the World Health Organization (WHO). Women's desire for birth companionship needs to be given attention during the antenatal care period to make them ready during labor and delivery. There is a dearth of study about the status of women's desire for birth companionship and associated factors.ObjectiveThis study aimed to assess the prevalence of desire for birth companionship and associated factors among pregnant women in Debremarkos city, northwest Ethiopia.MethodsInstitution-based cross-sectional study was conducted from February 1, 2021 to March 30, 2021 in Debremarkos city, northwest Ethiopia. A total of 423 participants were accessed by systematic random sampling. A face-to-face interviewer-administered questionnaire was employed. The data were entered into Epi data version 4.6 and transformed to SPSS version 25. Binary logistic regression analysis was done, and variables with a p-value ≤ 0.2 on bivariable analysis were taken for multivariable analysis. Adjusted odds ratio with a 95% confidence interval was used to detect the association, and a p-value of <0.05 in the multivariable analysis was used to declare statistical significance.ResultsThe prevalence of desire for birth companionship was 57.45% (52.6–62.2%). Women who were the primary decision-maker for maternal health care services [adjusted odds ratio (AOR) =3.0; 95% CI 1.7–5.6], women with planned pregnancy (AOR = 2.0; 95% CI 1.0–3.9), women who have no bad obstetric history (AOR = 2.3; 95% CI 1.2–4.4), and women whose 1st antenatal care visit starts within the second trimester (AOR = 2.6; 1.6–4.4) were statistically significant with desire on birth companionship.ConclusionsDesire of pregnant women for birth companionship was high in this study. Improving women's decision-making power, emphasis on the type of pregnancy, obstetrical history, and early initiation of antenatal care visit were the suggested areas to increase the desire of women for birth companionship.

show abstract

Coverage, associated factors, and impact of companionship during labor: A large‐scale observational study in six hospitals in Nepal

Cited by 11 publications

References 24 publications

Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

Partnership-defined quality approach to companionship during labour and birth in East New Britain, Papua New Guinea: A mixed-methods study

Desire for Birth Companionship Among Pregnant Women Attending Antenatal Care in Debremarkos City, Northwest Ethiopia: Magnitude and Associated Factors

Contact Info

Product

Resources

About