Unveiling respectful maternity care as a way to address global inequities in maternal health

Asefa, Anteneh

doi:10.1136/bmjgh-2020-003559

Cited by 25 publications

(17 citation statements)

References 25 publications

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“…These findings align with a 2015 systematic review by Bohren et al which found that health system factors, such as a lack of privacy or staffing shortages, can be experienced directly by women as mistreatment [ 3 ]. Our study’s findings are consistent with the global literature that suggests mistreatment is not merely an interpersonal problem, but is also driven by health system inadequacies that affect clients and providers alike [ 10 , 26 , 27 ].…”

Section: Discussionsupporting

confidence: 89%

An exploratory study of client and provider experience and perceptions of facility-based childbirth care in Quiché, Guatemala

Sethi¹,

Hill²,

Stalls

et al. 2022

BMC Health Serv Res

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Introduction Respectful maternity care (RMC) is fundamental to women’s and families’ experience of care and their decision about where to give birth. Studies from multiple countries describe the mistreatment of women during facility-based childbirth, though only a small number of studies from Guatemala have been published. Less information is available on women’s negative and positive experiences of childbirth care and health workers’ perceptions and experiences of providing maternity care. Methods As part of a program implemented in the Western Highlands of Guatemala to improve quality of reproductive maternal newborn and child health care, a mixed methods assessment was conducted in three hospitals and surrounding areas to understand women’s and health workers’ experience and perceptions of maternity care. The quantitative component included a survey of 31 maternity health workers and 140 women who had recently given birth in these hospitals. The qualitative component included in-depth interviews (IDIs) and focus group discussions (FGDs) with women and maternity health workers and managers. Results Women reported a mix of positive and negative experiences of childbirth care related to interpersonal and health system factors. 81% of surveyed women reported that health workers had treated them with respect while 21.4% of women reported verbal abuse. Fifty-five percent and 12% of women, respectively, reported not having access to a private toilet and bath or shower. During IDIs and FGDs, many women described higher rates of verbal abuse directed at women who do not speak Spanish. A regression analysis of survey results indicated that speaking Ixil or K’iche at home was associated with a higher likelihood of women being treated negatively during childbirth in a facility. Health worker survey results corroborated negative aspects of care described by women and also reported mistreatment of health workers by clients and families (70.9%) and colleagues (48.2%). Conclusions This study adds to the literature on women’s experience of institutional childbirth and factors that influence this experience by triangulating experience and perceptions of both women and health workers. This assessment highlights opportunities to address mistreatment of both women and health workers and to build on positive care attributes to strengthen RMC for all women.

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Section: Discussionsupporting

confidence: 89%

An exploratory study of client and provider experience and perceptions of facility-based childbirth care in Quiché, Guatemala

Sethi¹,

Hill²,

Stalls

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Asefa et al [43.] , [44.] states it is crucial to work towards strengthening health systems that are capable of promptly responding to shocks and upholding quality of care in times of public health crisis such as the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Midwives’ experiences of providing maternity care to women and families during the COVID-19 pandemic in Northern Italy

et al. 2023

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“…It requires structural/institutional commitments, policy backing, and human resource recalibration. Hence, continuous professional development would be to be implemented in order to reduce the occurrence of disrespect [ 35 ]. Our findings also emphasise the need to champion patient-centred care and a rights-based approaches in promoting RMC.…”

Section: Discussionmentioning

confidence: 99%

Promoting respectful maternity care: challenges and prospects from the perspectives of midwives at a tertiary health facility in Ghana

Dzomeku

Mensah

Nakua

et al. 2022

BMC Pregnancy Childbirth

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Background Evidence shows that women in Ghana experience disrespectful care (slapping, pinching, being shouted at, etc.) from midwives during childbirth. Hence, evidence-based research is needed to advance the adoption of respectful maternity care (RMC) by midwives. We therefore sought to explore and document midwives’ perspectives concerning challenges faced and prospects available for promoting RMC in a tertiary health facility. Methods We employed an exploratory descriptive qualitative study design. In total, we conducted 12 interviews with midwives educated on RMC. All audio data were transcribed verbatim and exported to NVivo-12 for data management and analyses. We relied on the Consolidated Criteria for Reporting Qualitative Research guideline in reporting this study. Results The findings were broadly categorised into three themes: emotional support, dignified care and respectful communication which is consistent with the WHO’s quality of care framework. For each theme, the current actions that were undertaken to promote RMC, the challenges and recommendations to improve RMC promotion were captured. Overall, the current actions that promoted RMC included provision of sacral massages and reassurance, ensuring confidentiality and consented care, and referring clients who cannot pay to the social welfare unit. The challenges to providing RMC were logistical constraints for ensuring privacy, free movement of clients, and alternative birthing positions. Poor attitudes from some midwives, workload and language barrier were other challenges that emerged. The midwives recommended the appointment of more midwives, as well as the provision of logistics to support alternative birthing positions and privacy. Also, they recommended the implementation of continuous training and capacity building. Conclusion We conclude that in order for midwives to deliver RMC services that include emotional support, dignified care, and respectful communication, the government and hospital administration must make the required adjustments to resolve existing challenges while improving the current supporting activities.

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Unveiling respectful maternity care as a way to address global inequities in maternal health

Abstract: To cite: Asefa A. Unveiling respectful maternity care as a way to address global inequities in maternal health.

Cited by 25 publications

References 25 publications

An exploratory study of client and provider experience and perceptions of facility-based childbirth care in Quiché, Guatemala

An exploratory study of client and provider experience and perceptions of facility-based childbirth care in Quiché, Guatemala

Midwives’ experiences of providing maternity care to women and families during the COVID-19 pandemic in Northern Italy

Promoting respectful maternity care: challenges and prospects from the perspectives of midwives at a tertiary health facility in Ghana

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