Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals
Objectives There is a lack of evidence on approaches to mitigating mistreatment during facility-based childbirth. This study compares the experiences of mistreatment reported by childbearing women before and after implementation of a respectful maternity care intervention.Design A pre–post study des...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e038871.full |
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| author | Samson Gebremedhin Anteneh Asefa Alison Morgan Michelle Kermode Hema Magge Ephrem Tekle Sintayehu Abebe |
| author_facet | Samson Gebremedhin Anteneh Asefa Alison Morgan Michelle Kermode Hema Magge Ephrem Tekle Sintayehu Abebe |
| author_sort | Samson Gebremedhin |
| collection | DOAJ |
| description | Objectives There is a lack of evidence on approaches to mitigating mistreatment during facility-based childbirth. This study compares the experiences of mistreatment reported by childbearing women before and after implementation of a respectful maternity care intervention.Design A pre–post study design was undertaken to quantify changes in women’s experiences of mistreatment during facility-based childbirth before and after the respectful maternity care intervention.Intervention A respectful maternity care intervention was implemented in three hospitals in southern Ethiopia between December 2017 and September 2018 and it included training of service providers, placement of wall posters in labour rooms and post-training supportive visits for quality improvement.Outcome measures A 25-item questionnaire asking women about mistreatment experiences was administered to 388 women (198 in the pre-intervention, 190 in the post-intervention). The outcome variable was the number of mistreatment components experienced by women, expressed as a score out of 25. Multilevel mixed-effects Poisson modelling was used to assess the change in mistreatment score from pre-intervention to post-intervention periods.Results The number of mistreatment components experienced by women was reduced by 18% when the post-intervention group was compared with the pre-intervention group (adjusted regression coefficient (Aβ)=0.82, 95% CI 0.74 to 0.91). Women who had a complication during pregnancy (Aβ=1.17, 95% CI 1.01 to 1.34) and childbirth (Aβ=1.16, 95% CI 1.03 to 1.32) experienced a greater number of mistreatment components. On the other hand, women who gave birth by caesarean birth after trial of vaginal birth (Aβ=0.76, 95% CI 0.63 to 0.92) and caesarean birth without trial of vaginal birth (Aβ=0.68, 95% CI 0.47 to 0.98) experienced a lesser number of mistreatment components compared with those who had vaginal birth.Conclusions Women reported significantly fewer mistreatment experiences during childbirth following implementation of the intervention. Given the variety of factors that lead to mistreatment in health facilities, interventions designed to mitigate mistreatment need to involve structural changes. |
| format | Article |
| id | doaj-art-23107f4b48054aff98c6fd9380be026e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-23107f4b48054aff98c6fd9380be026e2025-01-08T15:35:08ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-038871Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitalsSamson Gebremedhin0Anteneh Asefa1Alison Morgan2Michelle Kermode3Hema Magge4Ephrem Tekle5Sintayehu Abebe6School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumNossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, AustraliaNossal Institute for Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaDivision of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, USAMaternal and Child Health Directorate, Ministry of Health, Addis Ababa, EthiopiaDepartment of Public Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaObjectives There is a lack of evidence on approaches to mitigating mistreatment during facility-based childbirth. This study compares the experiences of mistreatment reported by childbearing women before and after implementation of a respectful maternity care intervention.Design A pre–post study design was undertaken to quantify changes in women’s experiences of mistreatment during facility-based childbirth before and after the respectful maternity care intervention.Intervention A respectful maternity care intervention was implemented in three hospitals in southern Ethiopia between December 2017 and September 2018 and it included training of service providers, placement of wall posters in labour rooms and post-training supportive visits for quality improvement.Outcome measures A 25-item questionnaire asking women about mistreatment experiences was administered to 388 women (198 in the pre-intervention, 190 in the post-intervention). The outcome variable was the number of mistreatment components experienced by women, expressed as a score out of 25. Multilevel mixed-effects Poisson modelling was used to assess the change in mistreatment score from pre-intervention to post-intervention periods.Results The number of mistreatment components experienced by women was reduced by 18% when the post-intervention group was compared with the pre-intervention group (adjusted regression coefficient (Aβ)=0.82, 95% CI 0.74 to 0.91). Women who had a complication during pregnancy (Aβ=1.17, 95% CI 1.01 to 1.34) and childbirth (Aβ=1.16, 95% CI 1.03 to 1.32) experienced a greater number of mistreatment components. On the other hand, women who gave birth by caesarean birth after trial of vaginal birth (Aβ=0.76, 95% CI 0.63 to 0.92) and caesarean birth without trial of vaginal birth (Aβ=0.68, 95% CI 0.47 to 0.98) experienced a lesser number of mistreatment components compared with those who had vaginal birth.Conclusions Women reported significantly fewer mistreatment experiences during childbirth following implementation of the intervention. Given the variety of factors that lead to mistreatment in health facilities, interventions designed to mitigate mistreatment need to involve structural changes.https://bmjopen.bmj.com/content/10/9/e038871.full |
| spellingShingle | Samson Gebremedhin Anteneh Asefa Alison Morgan Michelle Kermode Hema Magge Ephrem Tekle Sintayehu Abebe Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals BMJ Open |
| title | Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals |
| title_full | Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals |
| title_fullStr | Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals |
| title_full_unstemmed | Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals |
| title_short | Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals |
| title_sort | mitigating the mistreatment of childbearing women evaluation of respectful maternity care intervention in ethiopian hospitals |
| url | https://bmjopen.bmj.com/content/10/9/e038871.full |
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