Respectful maternity care and associated factors among mothers who gave birth at public health institutions in South Gondar Zone, Northwest Ethiopia 2021

Abstract

Introduction: Respectful maternity care is essential for improving maternal and neonatal health. Lack of respectful maternity care during childbirth services is one of the deterrents to women seeking facility-based deliveries. It is a health system failure and a violation of women’s rights. There is limited data on respectful maternity care during childbirth and maternity care in Ethiopia, particularly at rural health facilities. But studies have shown that many women from rural areas were more likely to report disrespect and abuse than urban residents. Objective: This study aims to assess respectful maternity care and associated factors among mothers who gave birth at health institutions in the South Gondar zone, northwest Ethiopia, 2021. Methods: A multicenter institutional-based cross-sectional study design was conducted among mothers who gave birth at South Gondar Zone public health institutions, from 1 February to 30 March 2021. Six hundred twenty-two study participants were selected by using systematic random sampling. The data were collected through face-to-face interviews using a pretested and semi-structured questionnaire. Data were entered into Epi-Data version 4.6 and exported to SPSS version 23 for analysis. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Result: A total of 611 participants were included in the study with the response rate of 98.2%. The study revealed that only 39.4%, of (95% confidence interval: 35.4–43.2) women received respectful maternity care. Completed secondary education (adjusted odds ratio: 2.47, 95% confidence interval: 1.35–4.50), having antenatal care follow-up (adjusted odds ratio: 0.098, 95% confidence interval: 0.03–0.34), planned pregnancy (adjusted odds ratio: 3.21, 95% confidence interval: 1.69–6.08), cesarean section delivery (adjusted odds ratio: 0.47, 95% confidence interval: 0.25–0.89), and daytime delivery (adjusted odds ratio: 1.9, 95% confidence interval: 1.33–2.72)) were significantly associated with respectful maternity care. Conclusion and Recommendation: Only two out of five women received respectful maternity care during childbirth. Completed secondary education, having antenatal care follow-up, pregnancy intended/wanted, daytime delivery, and cesarean section delivery were identified factors. Therefore, giving emphasis to creating awareness of care providers on the standards and categories of respectful maternity care, improving care provider–client discussion, monitoring, and reinforcing accountability mechanisms for health workers to improve respectful maternity care during labor and childbirth were recommended.

Disrespect and abuse during childbirth and associated factors among women: a cross-sectional study

“…Women with unintended pregnancies had a 2.3 times higher likelihood of experiencing disrespect during labor. Consistent with the ndings of the present study, Ferede et al also reported a higher incidence of disrespect among women with unwanted pregnancies [55]. The Bante study found that planned pregnancies tripled the odds of receiving Respectful Maternity Care (RMC) [56].…”

An assessment of the provision of women-friendly care and its associated factors among mothers who gave birth at public health institutions in South Gondar Zone, Northwest Ethiopia

“…Care that is provided with in a kind and friendly approach to women, using polite words, calling the woman by her name, and speaking the language the mother understands, it is measured by using seven requirements. A woman who answered “Yes” to all seven questions regarding friendly care was considered to have received it during labor and delivery ( 11 , 12 ).…”

“…According to the 2016 Ethiopia Demographic and Health Survey (EDHS) report, Ethiopia has one of the highest maternal mortality ratios (MMRs) globally, with 412 maternal deaths occurring per 100,000 live births ( 10 ). A negatively perceived quality of care in facility-based childbirth often prevents the use of facility-based delivery services, both in the present or in the future ( 11 ). According to a recent evaluation conducted in Ethiopia, 85% of the 103 surveyed women reported that their service experience had impacted their decision regarding their future place of delivery.…”

Respectful Maternal Care Experience in Low- and Middle-Income Countries: A Systematic Review

“…Daytime delivery (adjusted odds ratio: 0.47, 95% confidence interval: 0.25-0.89), cesarean section (adjusted odds ratio: 0.69-6.08), and other factors. Respectful maternity care was substantially linked with (adjusted odds ratio: 1.9, 95% confidence interval: 1.33-2.72) [40]. Only 7% women had a negative birth experience.…”