‘They treat you like you are not a human being’: Maltreatment during labour and delivery in rural northern Ghana

Moyer, Cheryl A.; Adongo, Philip Baba; Aborigo, Raymond; Hodgson, Abraham; Engmann, Cyril

doi:10.1016/j.midw.2013.05.006

Cited by 163 publications

(214 citation statements)

References 18 publications

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“…Some studies in sub-Saharan Africa have indicated that lack of responsiveness affects health facility utilization. In Ghana, low facility utilization was attributed to physical abuse, verbal abuse, neglect and discrimination by healthcare providers [22]. Provider attitude had a large influence on decisions to have facility childbirth in Tanzania and Ethiopia [23, 24].…”

Section: Discussionmentioning

confidence: 99%

“…The use of traditional herbs in pregnancy and delivery has been documented in other African countries and could be toxic to both the mother and the foetus [35]. Health care providers discourage women from using herbs in pregnancy because of hazardous side effects and the denial of taking traditional herbs may deter women from use of health facilities [22]. However, educating them about the hazardous effects may alter their perceptions.…”

Section: Discussionmentioning

confidence: 99%

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‘Born before arrival’: user and provider perspectives on health facility childbirths in Kapiri Mposhi district, Zambia

Phiri

Fýlkesnes

Ruano

et al. 2014

BMC Pregnancy Childbirth

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BackgroundMaternal mortality remains high in sub-Saharan Africa. Health facility intra-partum strategies with skilled birth attendance have been shown to be most effective to address maternal mortality. In Zambia, the health policy for pregnant women is to have facility childbirth, but less than half of the women utilize the facilities for delivery. ‘Born before arrival’ (BBA) describes childbirth that occurs outside health facility. With the aim to increase our understanding of trust in facility birth care we explored how users and providers perceived the low utilization of health facilities during childbirth.MethodsA qualitative study was conducted in Kapiri Mposhi, Zambia. Focus group discussions with antenatal clinic and outpatient department attendees were conducted in 2008 as part of the Response to Accountable priority setting and Trust in health systems project, (REACT). In-depth interviews conducted with women who delivered at home, their husbands, community leaders, traditional birth attendants, and midwives were added in 2011. Information was collected on perceptions and experiences of home and health facility childbirth, and reasons for not utilizing a facility at delivery. Data were analysed by inductive content analysis.ResultsPerspectives of users and providers were grouped under themes that included experiences related to promotion of facility childbirth, responsiveness of health care providers, and giving birth at home. Trust and quality of care were important when individuals seek facility childbirth. Safety, privacy and confidentiality encouraged facility childbirth. Poor attitudes of health providers, long distances and lack of transport to facilities, costs to buy delivery kits, and cultural ideals that local herbs speed up labour and women should exhibit endurance at childbirth discouraged facility childbirth.ConclusionTrust and perceived quality of care were important and influenced health care seeking at childbirth. Interventions that include both the demand and supply sides of services with prioritizing needs of the community could substantially improve trust and utilization of facilities at childbirth, and accelerate efforts to achieve MDG5.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2393-14-323) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

‘Born before arrival’: user and provider perspectives on health facility childbirths in Kapiri Mposhi district, Zambia

Phiri

Fýlkesnes

Ruano

et al. 2014

BMC Pregnancy Childbirth

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“…This agrees with a similar study in northern Ghana that revealed women perceive these treatments as inhumane, often requiring recurrent assurance, encouragement and friendliness from health staff to enable them return again for services. 20,23 Birth preparedness education given at antenatal sessions enabled women visit delivery centres prepared with bed linings and soaps as indicated by nurses prior to delivery. Soap for nurse or midwives was singled out however as the most demanded of the items.…”

Section: Delivery Conditions At the Facility Levelmentioning

confidence: 99%

“…Studies investigating women's accounts of interactions in delivery care have been documented in Ghana, however, no study investigated both women's perspectives of facility delivery and informal payment conditions for maternity care. 9,[20][21][22][23] This study aims to fill this knowledge gap in Ghana by examining women perceptions of facility delivery and informal payments experiences in rural Ghana. Examining these two measures; facility delivery conditions and informal payments provide a window of opportunity to unearth salient underpinnings affecting women use of birthing services in rural Ghana.…”

Section: Introductionmentioning

confidence: 99%

Beyond our labour pains: women experiences of informal payments and delivery room conditions at birth in the Bongo district of Ghana

Ayanore

Kuganab-Lem

Aryee

2016

Int J Community Med Public Health

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“…Sociocultural and economic influences including the desire for intergenerational continuity of childbirth practices, the role of the male partner and other family members in decision-making, perceived high cost of care and convenience of home birth also play a crucial role in poor utilization of facility-based childbirth care [12,16]. In addition, mistreatment, disrespect and abuse, and negligence by health workers have encouraged dissatisfaction, mistrust, and in many cases complete avoidance of facility-based birth [12,17-19]. As these multilevel effects have far-reaching consequences on obstetric outcomes, a focus on improving the quality of facility care represents the starting point to reverse poor obstetric outcomes in low-income settings.…”

Section: Introductionmentioning

confidence: 99%

Formative research and development of innovative tools for “Better Outcomes in Labour Difficulty” (BOLD): study protocol

et al. 2015

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BackgroundMost complications during labour and childbirth could be averted with timely interventions by skilled healthcare providers. Yet, the quality and outcomes of childbirth care remains suboptimal in many health facilities in low-resource settings. To accelerate the reduction of childbirth-related maternal, fetal and newborn mortality and morbidity, the World Health Organization has initiated the “Better Outcomes in Labour Difficulty” (BOLD) project to address weaknesses in labour care processes and better connect health systems and communities. The project seeks to develop a “Simplified, Effective, Labour Monitoring-to-Action” tool (SELMA) to assist healthcare providers to monitor labour and take decisive actions more efficiently; and by developing an innovative set of service prototypes and/or tools termed “Passport to Safer Birth”, designed with communities and healthcare providers, to promote access to quality care for women during childbirth. This protocol describes the formative research activities to support the development of these tools.Methods/DesignWe will employ qualitative research and service design methodologies in eight health facilities and their catchment communities in Nigeria and Uganda. In the health facilities, focus group discussions (FGD) and in-depth interviews (IDI) will be conducted among different cadres of healthcare providers and facility administrators. In the communities, FGDs and IDIs will be conducted among women who have delivered in a health facility. We will use service design methods to explore women’s journey to access and receive childbirth care in order to innovate and design services around the needs and expectations of women, within the context of the health system.DiscussionThis formative research will serve several roles. First, it will provide an in-depth understanding of healthcare providers and health system issues to be accounted for in the final design and implementation of SELMA. Second, it will help to identify key moments (“touch points”) where women’s experiences of childbirth care are shaped, and where the overall experience of quality care could be improved. The synthesis of findings from the qualitative and service design activities will help identify potential areas for behaviour change related to the provision and experience of childbirth care, and serve as the basis for the development of Passport to Safer Birth.Please see related articles ‘http://dx.doi.org/10.1186/s12978-015-0027-6’ and ‘http://dx.doi.org/10.1186/s12978-015-0029-4’.

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‘They treat you like you are not a human being’: Maltreatment during labour and delivery in rural northern Ghana

Cited by 163 publications

References 18 publications

‘Born before arrival’: user and provider perspectives on health facility childbirths in Kapiri Mposhi district, Zambia

‘Born before arrival’: user and provider perspectives on health facility childbirths in Kapiri Mposhi district, Zambia

Beyond our labour pains: women experiences of informal payments and delivery room conditions at birth in the Bongo district of Ghana

Formative research and development of innovative tools for “Better Outcomes in Labour Difficulty” (BOLD): study protocol

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