Dataset Information

Prevalence and risk factor for mistreatment in childbirth: In health facilities of Gondar city, Ethiopia.

ABSTRACT:

Background

Providing compassionate and respectful maternity care to mothers is a vital intervention to improve health outcomes of women and newborns. However, there is less data of compassionate and respectful maternity care in Gondar city. Therefore, this study aimed to assess the magnitude of mistreatment and associated factors among mothers who gave birth at the public health facilities in Gondar city, northwest Ethiopia.

Methods

Institutional based cross-sectional study was conducted from March to April 2019 in Gondar city public nine health facilities. A total of 584 randomly selected women in the postpartum period were recruited in this study. A binary logistic regression analysis was done to see whether there was an association between mistreatment and independent variables. Finally, the logistic regression analysis was done by stratifying type of parity and mode of delivery.

Results

Overall, 73.2% (95% CI: 69.7-76.7%) of the women were mistreated during their childbirth care. Non-consented care was the most commonly experienced form of mistreatment (63.6%, 95% CI: 59.6-67.6%). Having less than four antenatal care follow-up visits (AOR = 3.58, 95% CI: 2.04-6.29), giving birth in the hospital (AOR = 2.83, 95% CI: 1.52-5.27), and facing complications during delivery (AOR = 2.06, 95% CI: 1.52-3.98) were significantly associated with mistreatment among postpartum mothers.

Conclusions

This study showed a lower proportion of mistreatment than other studies in Ethiopia. Having less than four ANC follow up, place of current delivery, and facing complication during delivery were identified as the determinants of mistreatment. Therefore, this calls for strengthening actions, like providing maternity education during antenatal care and appropriate management of complications to improve the quality of maternity care at health facilities, and enhancing hospital working health workers capacity on compassionate and respectful maternity care.

SUBMITTER: Shemelis D

PROVIDER: S-EPMC9070956 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Prevalence and risk factor for mistreatment in childbirth: In health facilities of Gondar city, Ethiopia.

Shemelis Dagmawit D Gelagay Abebaw Addis AA Boke Moges Muluneh MM

PloS one 20220505 5

<h4>Background</h4>Providing compassionate and respectful maternity care to mothers is a vital intervention to improve health outcomes of women and newborns. However, there is less data of compassionate and respectful maternity care in Gondar city. Therefore, this study aimed to assess the magnitude of mistreatment and associated factors among mothers who gave birth at the public health facilities in Gondar city, northwest Ethiopia.<h4>Methods</h4>Institutional based cross-sectional study was co ...[more]

PMID: 35511932

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Project description:BackgroundRecent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors.MethodsA two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling.ResultsA total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028).ConclusionMistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.

Project description:IntroductionFamily planning program is low-cost and an effective way to lower maternalmortality by reducing the number of high-risk births. Despite the effectiveness of the program, availability of materials, equipment and trained healthcare providers were some of the challenges in sub-Saharan African countries including Ethiopia. Determining the implementation status and identifying gaps is the aim of this evaluation.MethodA facility-based cross-sectional evaluation design with mixed method approach was employed. Quantitative data was collected through the exit interview of 477 clients from March 25-April 25, 2020. The evaluation focused on three dimensions: availability, compliance, and acceptability with multiple data sources. The quantitative data were entered in to Epi-data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done to determine factors associated with client satisfaction. The qualitative data were transcribed, translated and analyzed by using thematic analysis. The evaluation finding was computed and compared with the preset criteria for the final judgment.ResultThe majority of the health care providers (69.8%) got family planning training in the past two years. Three health facilities (37.5%) had 24hrs electricity with backup generators whereas only 25% of the health facilities had functional piped water inside the service room. Only two (25%) health facilities had a separate room for family planning service and 37.5% of health facilities had national FP guidelines. The overall availability of required resources for family planning service at Gondar city public facilities were 62.1%. Only twenty one (26.3%) of health providers dressed based on dressing code of ethics and none of them had ID during our observation. The overall compliance level of health care providers during providing family planning services were 75.5%. About 53.9% of the clients were satisfied with family planning service provided at Gondar city public health facilities.-and-were significantly associated variables with client satisfaction.ConclusionThe overall implementation of family planning service in Gondar city public health facilities with the three evaluation dimensions were judged as fair based on pre-setting judgment matrix. It is better to improve the service through training of healthcare providers, distributed family planning guidelines to health facilities and shortening of waiting time for service.

Project description:BackgroundDespite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon.Methods and findingsWe searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology.ConclusionsThis systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.

Project description:BackgroundPatient experience of care reflects the quality of health care in health facilities. While there are multiple studies documenting abuse and disrespect to women during childbirth, there is limited evidence on the mistreatment of newborns immediately after childbirth. This paper addresses the evidence gap by assessing the prevalence and risk factors associated with mistreatment of newborns after childbirth in Nepal, based on a large-scale observational study.Methods and findingsThis is a prospective observational cohort study conducted over a period of 18 months in 4 public referral hospitals in Nepal. All newborns born at the facilities during the study period, who breathed spontaneously and were observed, were included. A set of indicators to measure mistreatment for newborns was analysed. Principal component analysis was used to construct a single newborn mistreatment index. Uni-variate, multi-variate, and multi-level analysis was done to measure the association between the newborn mistreatment index and demographic, obstetric, and neonatal characteristics. A total of 31,804 births of newborns who spontaneously breathed were included. Among the included newborns, 63.0% (95% CI, 62.5-63.5) received medical interventions without taking consent from the parents, 25.0% (95% CI, 24.5-25.5) were not treated with kindness and respect (roughly handled), and 21.4% (95% CI, 20.9-21.8) of them were suctioned with no medical need. Among the newborns, 71.7% (95% CI, 71.2-72.3) had the cord clamped within 1 minute and 77.6% (95% CI, 77.1-78.1) were not breast fed within 1 hour of birth. Only 3.5% (95% CI, 3.2-3.8) were kept in skin to skin contact in the delivery room after birth. The mistreatment index showed maximum variation in mistreatment among those infants born to women of relatively disadvantaged ethnic groups and infants born to women with 2 or previous births. After adjusting for hospital heterogeneity, infants born to women aged 30-34 years (β, -0.041; p value, 0.01) and infants born to women aged 35 years or more (β, -0.064; p value, 0.029) were less mistreated in reference to infants born to women aged 18 years or less. Infants born to women from the relatively disadvantaged (chhetri) ethnic groups (β, 0.077; p value, 0.000) were more likely to be mistreated than the infants born to relatively advantaged (brahmin) ethnic groups. Female newborns (β, 0.016; p value, 0.015) were more likely to be mistreated than male newborns.ConclusionsThe mistreatment of spontaneously breathing newborns is high in public hospitals in Nepal. Mistreatment varied by hospital, maternal ethnicity, maternal age, and sex of the newborn. Reducing mistreatment of newborns will require interventions at policy, health system, and individual level. Further, implementation studies will be required to identify effective interventions to reduce inequity and mistreatment of newborns at birth.

Project description:BackgroundHypertension is a disease that imposes risks of diseases on multi-system. Failure to control hypertension leads patients to end up with unavoidable complications, including death. Noncompliance to treatment is the main factor to develop such devastating complications whereas knowledge of patients about their disease is a key factor for better compliance. Thus, the purpose of this study is to assess the level of knowledge about hypertension and associated factors among hypertensive patients in public health facilities of Gondar city.MethodsFacility-based cross-sectional study was conducted between March and April 2019 in Gondar town. A systematic sampling technique was applied to select a total of 389 patients. A structured interview questionnaire was used to gather the data. The data were analyzed using STATA version 14. Ordinal logistic regression analysis was performed at P < 0.05 with a 95% confidence interval to identify statistically significant variables.ResultsA total of 385 respondents participated giving a response rate of 98.9%. The majority (55.3%) of the patients had a low level of, 17.9% had a moderate level of knowledge whereas 26.8% had a high level of knowledge about hypertension. Those working in government organizations had 5.5 times higher odds of having a high level of knowledge than other groups (AOR = 5.5; 95%CI = 1.21, 25). Patients who received longer than four years of treatment showed twice larger odds of knowledge than those with below two years of treatment (AOR = 2; 95%CI = 1.29, 3.22) Moreover, patients residing proximate to the hospital increases the odds of having a higher level of knowledge by 1.64 times versus patients living far away from the hospital (AOR = 1.64, 95% CI = 1.07-2.63).ConclusionsThis finding revealed that knowledge about hypertension and risk factors among patients with hypertension was low. Employment in governmental organizations, longer duration of treatment, and residential proximity to hospitals/ health centers were statistically significant predictors of the participants' knowledge about hypertension. Therefore, it is important to give health education to patients working in non-governmental organizations and self-employed individuals about diseases and risk factors. In addition, emphasis should be given to patients receiving less than two years of treatment and coming from remote areas to improve their knowledge of the disease.

Dataset Information

Prevalence and risk factor for mistreatment in childbirth: In health facilities of Gondar city, Ethiopia.

Background

Methods

Results

Conclusions

Publications

Prevalence and risk factor for mistreatment in childbirth: In health facilities of Gondar city, Ethiopia.

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