Promoting respectful maternity care in rural Tanzania: nurses’ experiences of the “Health Workers for Change” program

Abstract

BackgroundDisrespectful and abusive care of women during their pregnancies has been shown to be a barrier for women accessing health care services for antenatal care and delivery. As part of an implementation research study to improve women’s access to health care services in Rorya District, Mara, Tanzania, we conducted a pilot study training reproductive health care nurses to be more sensitive to women’s needs based on the “Health Workers for Change” curriculum.MethodsSix series of workshops were held with a total of 60 reproductive health care nurses working at the hospitals, health centres and dispensaries in the district. The participants provided comments on a survey and participated in focus groups at the conclusion of the workshop series. These qualitative data were analyzed for common themes.ResultsThe participants appreciated the training and reflected on the poor quality of health care services they were providing, recognizing their attitudes towards their women patients were problematic. They emphasized the need for future training to include more staff and to sustain positive changes. Finally, they made several suggestions for improving women’s experiences in the future.ConclusionsThe qualitative findings demonstrate the success of the workshops in assisting the health care providers to become aware of their negative attitudes towards women. Future research should examine the impact of the workshops both on sustaining attitudinal changes of the providers and on the experiences of pregnant women receiving health care services.

Clinical cascades as a novel way to assess physical readiness of facilities for the care of small and sick neonates in Kenya and Uganda

“…The WHO has developed a quality of care framework for pregnant women and newborns in facilities, which highlights the overarching need for both competent human resources and essential physical resources and additionally requires evidence-based practices for routine and emergency care; actionable information systems; functional referral systems; effective communication; respect and dignity; and emotional support [ 57 ]. In recent years, increased emphasis has been placed on promotion of respectful maternity care and elimination of abuse during childbirth [ 58 – 60 ]. One study found that women who experience discrimination or abuse during childbirth are less likely to seek facility-based delivery care in the future [ 61 ]; such experiences may also deter postnatal care-seeking [ 12 ].…”

Respectful family planning service provision in Sidama zone, Southern Ethiopia

“…The training program had a positive impact on the quality of counseling family planning services, providers' interpersonal skills and overall knowledge (38). This is supported by a pilot study training reproductive health care nurses on promoting respectful maternity care which concluded that the training has positive impact on promoting respectful care (39).…”

Midwives’ identity and perspectives on the occurrence of disrespect and abuse in Maputo city: a qualitative study

“…And we have to do it with our heart, that is most important." (Midwife, FGD 5, age group [41][42][43][44][45][46][47][48][49][50] Most women are also satis ed and happy after the delivery, and especially at the maternity ward the contact with women was told to be positive.…”

“…Furthermore, midwives' educational curriculum should include proper training about (pain) mechanisms during labour for avoiding such negative reasoning that might constitute to D&A. Some promising results have been found from the implementation of a workshop called "Health Workers for Change" in Tanzania covering re ection and discussion about different topics such as own values, women's status in society and overcoming obstacles at work [50]. The Population Council's Heshima Project in Kenya successfully used a similar approach [51].…”