Assessment of Mothers’ Experience of Disrepect and Abuse during Maternal Health Care Provision and Associated Factors, In Public and Private Health Facilities in Addis Ababa
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Date
2021-09
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Addis Ababa University
Abstract
Disrespect and abuse of women during labor and delivery is becoming recognized as a violat
ion of their rights and a barrier to using life-saving, facility-based labor and delivery care.
In Addis Ababa, the rate of expert birth attendance is 97 percent, with the remaining women
giving birth at home. From the viewpoints of both providers and mothers, this study investiga
tes the experiences of disrespect and abuse in maternal care, as well as the factors associated
with facility-based maternal care.
We conducted 455 interviewer-administered structured interviews at two randomly selected
governmental health facilities with their four-catchment health centers and two hospitals of
privately owned hospitals in Addis Ababa Ethiopia with midwives, health officers, nurses,
and medical doctors, and women who had given birth within the three months prior to the
survey date. In addition to the quantitative survey, the mothers who experienced disrespect
and abuse took part in an in-depth interview.
We discovered that during labor and delivery, both health care providers and women who pa
rticipated in an in-depth interview reported physical and verbal abuse, as well as nonconsented care. Most abuse, according to providers, is unintentional and stems from the over
crowding of the labor ward as a result of inappropriate referrals. We uncovered no evidence
of more systematic types of abuse involving the detention of patients from living with her
new-born rather than restraining women in the facility because they failed to pay health care
fees. Most of the mothers reported that they were never asked to know the position she
prefers to deliver in yet and also, they were denied to deliver in the position she preferred.
However, it is small in number the disrespect and abuse that they shy away to report also
appeared during the quantitative survey.
Our findings recommend that respectful care training, which is included in the national midw
ifery curriculum's professional ethics modules, be expanded to include a stronger emphasis
on counseling skills and rapport building. Our findings also suggest that all treatments aimed
at improving midwives' interpersonal contacts with women should be supplemented by addre
ssing structural concerns related to provider workload.
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Keywords
Midwives, Respectful maternity care, Disrespect and abuse, Maternity care, Quality, Patients’ rights, unnecessary referrals