How women are treated during facility-based childbirth: development and validation of measurement tools in four countries – phase 1 formative research study protocol

Reproductive Health

Metin A. Gülmezoglu^1,13  Hadiza Idris^1,14  Frank Alu²  Musibau Titiloye⁷  Lanre Olutayo⁶  Theingi Myint^1,10  Khin Thet Wai³  Safiatou Diallo¹  Alfa Boubacar Diallo⁵  Mohamed Campell Camara^1,12  Ernest Tei Maya⁴  Phyllis Dako-Gyeke⁴  Kwame Adu-Bonsaffoh⁸  Bukola Fawole^1,11  Thae Maung Maung³  Mamadou Diouldé Baldé¹  Richard M. Adanu⁴  Olufemi T. Oladapo^1,13  Özge Tunçalp^1,13  Meghan A. Bohren⁹  Joshua P. Vogel^1,13 

[1] Cellule de Recherche en Santé de la Reproduction en Guinée (CERREGUI), Enceinte Hôpital National Donka, Conakry, Guinea;Department of Obstetrics & Gynaecology, Maitama District Hospital, Abuja, Nigeria;Department of Medical Research, Yangon, Myanmar;School of Public Health, University of Ghana, Accra, Ghana;Service de Gynécologie-Obstétrique, Hôpital national universitaire de Conakry, Conakry, Guinea;Department of Sociology, Faculty of The Social Sciences, University of Ibadan, Ibadan, Nigeria;Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria;Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana;Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, USA;Maternal and Reproductive Health Division, Department of Public Health, Naypyitaw, Myanmar;University of Ibadan, Ibadan, Nigeria;Departement de sociologie Université, Sonfonia, Conakry, Guinea;Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Avenue Appia 20, Geneva, 1201, Switzerland;Department of Obstetrics & Gynaecology, Nyanya General Hospital, Abuja, Nigeria

关键词: Qualitative research;    Quality of care;    Neglect;    Abuse;    Disrespect;    Mistreatment;    Childbirth;    Obstetric delivery;    Maternal health;   

Others  :  1221219
DOI  :  10.1186/s12978-015-0047-2

 received in 2015-05-22, accepted in 2015-06-07,  发布年份 2015

【 摘 要 】

Background

Every woman has the right to dignified, respectful care during childbirth. Recent evidence has demonstrated that globally many women experience mistreatment during labour and childbirth in health facilities, which can pose a significant barrier to women attending facilities for delivery and can contribute to poor birth experiences and adverse outcomes for women and newborns. However there is no clear consensus on how mistreatment of women during childbirth in facilities is defined and measured. We propose using a two-phased, mixed-methods study design in four countries to address these research gaps. This protocol describes the Phase 1 qualitative research activities.

Methods/Design

We will employ qualitative research methodologies among women, healthcare providers and administrators in the facility catchment areas of two health facilities in each country: Ghana, Guinea, Myanmar and Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) will be conducted among women of reproductive age (15–49 years) to explore their perceptions and experiences of facility-based childbirth care, focused on how they were treated by healthcare workers and perceived factors affecting how they were treated. IDIs will also be conducted with healthcare providers of different cadres (e.g.: nurses, midwives, medical officers, specialist obstetricians) and facility administrators working in the selected facilities to explore healthcare providers’ perceptions and experiences of facility-based childbirth care and how staff are treated, colleagues and supervisors. Audio recordings will be transcribed and translated to English. Textual data will be analysed using a thematic framework approach and will consist of two levels of analysis: (1) conduct of local analysis workshops with the research assistants in each country; and (2) line-by-line coding to develop a thematic framework and coding scheme.

Discussion

This study serves several roles. It will provide an in-depth understanding of how women are treated during childbirth in four countries and perceived factors associated with this mistreatment. It will also provide data on where and how an intervention could be developed to reduce mistreatment and promote respectful care. The findings from this study will contribute to the development of tools to measure the prevalence of mistreatment of women during facility-based childbirth.

【 授权许可】

   
2015 Vogel et al.

【 参考文献 】

• [1]Trends in maternal mortality: 1990 to 2013. World Health Organization, Geneva; 2013.
• [2]Nations U. Millennium development goals report 2014. United Nations, New York; 2014.
• [3]Tunçalp Ӧ, Were WM, MacLennan C, Oladapo OT, Gülmezoglu AM, Bahl R, Daelmans B, Mathai M, Say L, Kristensen F, Temmerman M, Bustreo F. BJOG. 2015 May 1. doi: 10.1111/1471-0528.13451. [Epub ahead of print] Quality of care for pregnant women and newborns-the WHO vision.
• [4]UN General Assembly. Universal declaration of human rights. UN General Assembly; 1948.
• [5]Fujita N, Perrin XR, Vodounon JA, Gozo MK, Matsumoto Y, Uchida S, et?al. Humanised care and a change in practice in a hospital in Benin. Midwifery. 2012;28(4):481–8.
• [6]UN General Assembly. Declaration on the elimination of violence against women. UN General Assembly; 1993.
• [7]Redshaw MM, Hockley CC. Institutional processes and individual responses: women’s experiences of care in relation to cesarean birth. Birth. 2010; 37(2):150-9.
• [8]UN General Assembly. International covenant on economic, social and cultural rights. UN General Assembly; 1976.
• [9]Kruger L-M, Schoombee C. The other side of caring: abuse in a South African maternity ward. J Reprod Infant Psychol. 2009; 99999(1):1-18.
• [10]El-Nemer A, Downe S, Small N. “She would help me from the heart”: an ethnography of Egyptian women in labour. Soc Sci Med. 2005; 62(1):81-92.
• [11]Chalmers B, Omer-Hashi K. What Somali women say about giving birth in Canada. J Reprod Infant Psychol. 2001; 20(4):267-82.
• [12]Janevic T, Sripad P, Bradley E, Dimitrievska V. “There’s no kind of respect here” A qualitative study of racism and access to maternal health care among Romani women in the Balkans. Int J Equity Health. 2010; 10(1):53-3. BioMed Central Full Text
• [13]Mselle LT, Moland KM, Mvungi A, Evjen-Olsen B, Kohi TW. Why give birth in health facility? Users “and providers” accounts of poor quality of birth care in Tanzania. BMC Health Serv Res. 2012; 13:174-4. BioMed Central Full Text
• [14]Silal SP, Penn-Kekana L, Harris B, Birch S, McIntyre D. Exploring inequalities in access to and use of maternal health services in South Africa. BMC Health Serv Res. 2011; 12:120. BioMed Central Full Text
• [15]Jewkes R, Abrahams N, Mvo Z. Why do nurses abuse patients? Reflections from South African obstetric services. Soc Sci Med. 1997; 47(11):1781-95.
• [16]Moyer CA, Adongo PB, Aborigo RA, Hodgson A, Engmann CM. “They treat you like you are not a human being”: maltreatment during labour and delivery in rural northern Ghana. Midwifery. 2014; 30(2):262-8.
• [17]Bohren MA, Hunter EC, Munthe-Kaas HM, Souza JP, Vogel JP, Gulmezoglu AM. Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health. 2013; 11(1):71-1. BioMed Central Full Text
• [18]Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth: report of a landscape analysis. USAID / TRAction Project; 2010.
• [19]Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Kudesia K, Souza JP, Aguiar C, Saraiva F, Diniz A, Tunçalp Ö, Javadi D, Oladapo OT, Khosla R, Hindin MJ, Gülmezoglu AM (2015). The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review. PLOS Medicine, 12(6):e1001847. doi:10.1371/journal.
• [20]Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts C. WHO multi-country study on women’s health and domestic violence against women. World Health Organization, Geneva; 2005.
• [21]Nations U. Millennium development goals report 2013. United Nations, New York; 2013.
• [22]White Ribbon Alliance. Respectful maternity care: the universal rights of childbearing women. White Ribbon Alliance; 2011.
• [23]Warren C, Njuki R, Abuya T, Ndwiga C, Maingi G, Serwanga J, et?al. Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2012;13:21–1.
• [24]Kruk ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plan. 2014. http://heapol. oxfordjournals.org/content/early/2014/09/21/heapol.czu079.abstract webcite
• [25]Sando D, Kendall T, Lyatuu G, Ratcliffe H, McDonald K, Mwanyika-Sando M, et?al. Disrespect and abuse during childbirth in Tanzania: are women living with HIV more vulnerable? J Acquir Immune Defic Syndr. 2014;67 Suppl 4:S228–34.
• [26]Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. Int J Gynaecol Obstet. 2015; 128(2):110-3.
• [27]Putting women first: ethical and safety recommendations for research on domestic violence against women. World Health Organization, Geneva; 2001.
• [28]The state of the world’s children 2014 [internet]. UNICEF, New York; 2015.