Assess Knowledge, Attitude and Practices of Respectful Maternity Care among nurse midwives in Referral Hospitals of Bhutan

Deki, Sonam; Choden, Jigme

doi:10.47811/bhj.50

Cited by 7 publications

(7 citation statements)

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“…In Bhutan, all deliveries are conducted in government health centres – there are no private clinics. Although deliveries are conducted free of cost, reported factors such as women in labour not being allowed to adopt preferred birth position, not allowing women to eat food and abuse from staff demonstrate lack of respectful maternity care [ 42 ]. While the government has initiated policies and procedures, additional efforts are urgently needed to create an environment for respectful normal deliveries in hospitals which may in turn reduce the proportion of maternal requests for elective caesarean sections.…”

Section: Discussionmentioning

confidence: 99%

Rates and indications of caesarean section deliveries in Bhutan 2015–2019: a national review

Dorji¹,

Dorji

Gyamtsho

et al. 2021

BMC Pregnancy Childbirth

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Background Bhutan has made much efforts to provide timely access to health services during pregnancy and increase institutional deliveries. However, as specialist obstetric services became available in seven hospitals in the country, there has been a steady increase in the rates of caesarean deliveries. This article describes the national rates and indications of caesarean section deliveries in Bhutan. Methods This is a review of hospital records and a qualitative analysis of peer-reviewed articles on caesarean deliveries in Bhutan. Data on the volume of all deliveries that happened in the country from 2015 to 2019 were retrieved from the Annual Health Bulletins published by the Ministry of Health. The volume of deliveries and caesarean deliveries were extracted from the Annual Report of the National Referral Hospital 2015–2019 and the data were collected from hospital records of six other obstetric centres. A national rate of caesarean section was calculated as a proportion out of the total institutional deliveries at all hospitals combined. At the hospital level, the proportion of caesarean deliveries are presented as a proportion out of total institutional deliveries conducted in that hospital. Results For the period 2015–2019, the average national rate of caesarean section was 20.1% with a statistically significant increase from 18.1 to 21.5%. The average rate at the six obstetric centres was 29.9% with Phuentsholing Hospital (37.2%), Eastern Regional Referral Hospital (34.2%) and Samtse General Hospital (32.0%) reporting rates higher than that of the National Referral Hospital (28.1%). Except for the Eastern Regional Referral and Trashigang Hospitals, the other three centres showed significant increase in the proportion of caesarean deliveries during the study period. The proportion of emergency caesarean section at National Referral Hospital, Central Regional Referral Hospital and the Phuentsholing General Hospital was 58.8%. The National Referral Hospital (71.6%) and Phuentsholing General Hospital reported higher proportions of emergency caesarean sections (64.4%) while the Central Regional Referral Hospital reported higher proportions of elective sections (59.5%). The common indications were ‘past caesarean section’ (27.5%), foetal distress and non-reassuring cardiotocograph (14.3%), failed progress of labour (13.2%), cephalo-pelvic disproportion or shoulder dystocia (12.0%), and malpresentation including breech (8.8%). Conclusion Bhutan’s caesarean section rates are high and on the rise despite a shortage of obstetricians. This trend may be counterproductive to Bhutan’s efforts towards 2030 Sustainable Development Goal agendas and calls for a review of obstetric standards and practices to reduce primary caesarean sections.

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Section: Discussionmentioning

confidence: 99%

Rates and indications of caesarean section deliveries in Bhutan 2015–2019: a national review

Dorji¹,

Dorji

Gyamtsho

et al. 2021

BMC Pregnancy Childbirth

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“…Based on the available evidence, negative attitudes and behaviors by maternity healthcare providers (MHCPs) are important predictors of mistreatment and a key barrier to quality of care and RMC [25][26][27][28][29]. MHCPs play important role in shaping the experiences (negative or positive) of pregnant and/or birthing women [25,[30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitude and practice of healthcare providers on mistreatment during labour and childbirth: a cross-sectional study in Tehran, Iran, 2021

Mirzania

Shakibazadeh

Bohren

et al. 2022

Preprint

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Background: Mistreatment of women during childbirth is a global health challenge. Maternity healthcare providers have key roles in influencing women’s birth experiences. This study aimed to assess knowledge, attitudes and practices of maternity healthcare providers about mistreatment during labour and childbirth in public hospitals in Tehran, Iran.Methods: This cross-sectional study was conducted from October to December 2021 in five public hospitals in Tehran. All maternity healthcare providers (obstetricians, midwives) and students were invited to the study. Data were collected using a questionnaire consisting of four sections: socio-demographic characteristics (11 items), knowledge (11 items), attitudes (13 items), and practices (14 items) about mistreatment. Knowledge, attitude, and practice levels were determined using Bloom’s cut off point. Data were analyzed using descriptive and analytical statistics at a significant level of p < 0.05.Results: A total of 255 individuals participated (response rate: 94.5%). Most participants (82.7%) had poor knowledge about physical abuse, verbal abuse, poor rapport between women and providers, and failure to meet professional standards of care. Most participants (69.4%) were alright with physical abuse, verbal abuse, and discrimination. Self-reported practices of different types of mistreatment were not common and only 3.1% of the participants were in moderate level. However, shouted at women, applied fundal pressure, and slapped the thighs during birth were categories used by providers. Age, profession, field of study, employment status, monthly income, work experience, numbers of night shifts, and training history were significantly related with the participants’ knowledge, attitudes, and practices about mistreatment.Conclusions: Knowledge, attitudes, and practices of our participants were poor about maternity mistreatment. Findings of our study have important implications for program planners and decision makers on development of effective interventions to reduce mistreatment during labour and childbirth in Iran. These interventions should include designing and implementing continuing education courses and revising the educational curriculums to increase knowledge, strengthen positive attitudes, and modify practice of maternity healthcare providers, overcoming staff shortages, paying staff fairly, establishing support culture for mother-centered and respectful care, and increasing quality of maternity care.

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“…They are associated with women's feelings of being overlooked, being informed of difficult news without proper preparation, being subjected to repetitive examinations without a reason being properly communicated, companions being disallowed, and being left unattended during facility-based maternity care [31]. Moreover, disrespect and abuse during childbirth are attributed to service delivery level factors such as lack of infrastructure and lack of responsibility mechanisms in the facility, and individual-level factors including the mothers' socio-demographic characteristics, lack of autonomy, obstetric history and the provider's perspectives [32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

Magnitude and associated factors of disrespect and abusive care among laboring mothers at public health facilities in Borena District, South Wollo, Ethiopia

Maldie¹,

Egata

Chanie

et al. 2021

PLoS ONE

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Background Recent studies have indicated that disrespectful/abusive/coercive service by skilled care providers in health facilities that results in actual or perceived poor quality of care is directly and indirectly associated with adverse maternal and newborn outcomes. According to the 2016 Ethiopian Demography and Health Survey, only 26% of births were attended by qualified clinicians, with a maternal mortality rate of 412 per 100,000 live-births. Using seven categories developed by Bowser and Hill (2010), this study looked at disrespect and abuse experienced by women in labor and delivery rooms in health facilities of Borena Ddistrict, South Wollo, Ethiopia. Methods A facility-based cross-sectional study was conducted among 374 immediate postpartum women in Borena District from January 12 to March 12, 2020. Systematic sampling was used to access respondents to participate in a structured, pre-tested face-to-face exit interview. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Finally, bivariable and multivariable logistic regression analysis were performed to declare statistically significant factors related to maternal disrespect and abusive care in Borena District at a p-value of < 0.05 and at 95% CI. Result Almost four out of five (79.4%) women experienced at least one type of disrespect and abuse during facility-based childbirth. The most frequently reported type of disrespect and abuse was non-consented care 63.7%. Wealth index [AOR = 3.27; 95% CI: (1.47, 7.25)], type of health facility [AOR = 1.96; 95% CI: (1.01, 3.78)], presence of companion(s) [AOR = 0.05; 95% CI: (0.02, 0.12)], and presence of complications [AOR = 2.65; 95% CI: (1.17, 5.99)] were factors found to be significantly related to women experiencing disrespect and abuse. Conclusion The results showed that wealth index, type of health facility, presence of companion(s), and birth complications were found to be significant factors. Therefore, health personnel need to develop interventions that integrate provider’s behavior on companionship and prevention of complications across facilities to reduce the impact of disrespectful and abusive care for laboring women.

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Assess Knowledge, Attitude and Practices of Respectful Maternity Care among nurse midwives in Referral Hospitals of Bhutan

Cited by 7 publications

References 0 publications

Rates and indications of caesarean section deliveries in Bhutan 2015–2019: a national review

Rates and indications of caesarean section deliveries in Bhutan 2015–2019: a national review

Knowledge, attitude and practice of healthcare providers on mistreatment during labour and childbirth: a cross-sectional study in Tehran, Iran, 2021

Magnitude and associated factors of disrespect and abusive care among laboring mothers at public health facilities in Borena District, South Wollo, Ethiopia

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