Disrespect and abuse of women during childbirth in public health facilities in Arba Minch town, South Ethiopia – a cross-sectional study

Abstract

21Introduction: Disrespect and abuse during childbirth is the main deterring factor to skilled birth 22 utilization as compared to other more commonly known factors such as financial and physical 23 inaccessibility. 24 Objective: To assess the occurrence of women's disrespect and abuse during childbirth in public health 25 facilities in Arba Minch town, south Ethiopia. 26 Methods: Institution based cross-sectional study design was employed at all public health institutions in 27 Arba Minch town, south Ethiopia. Systematic sampling method was used to include 281 women who had 28 given birth at public health institutions between January 01 and February 28, 2017. Data were collected 29 by face to face interview by four midwife tutors and supervised by the principal investigator on daily 30 bases. Semi-structured pretested questionnaire was used to collect data. Epi info version 7.1.2.0 and SPSS 31 version 24 were used to enter and analyze the data respectively. 32 Results: A total of 281 women were participated in this study. The overall prevalence of non-respectful 33 care was 98.9%. The women's right to information and informed consent was the most frequently 34 violated right with a prevalence of 92.5% (95% CI: 90.9, 94.1) followed by non-dignified care (36.7, 95% 35 CI: 34.9, 38.5), physical abuse (29.5%, 95% CI: 24.2, 34.8), discrimination (18.1%, 95% CI: 13.6, 22.6), 36non-confidential care (17.1%, 95% CI: 12.7, 21.5) and abandonment of care (4.3%, 95% CI: 3.1, 5.5). 37However, there is no woman who had been kept in detention in the health facilities. Being rural resident, 38giving birth in hospital, having no or low educational status and giving birth by cesarean route were 39 factors which were significantly associated with specific women's rights violations.3 40 Conclusions and recommendations:The status of non-respectful and abusive care in the health 41 care facilities in this study area is unacceptably high and needs serious attention by the health managers to 42 tackle the problem. 43

Disrespect and Abuse During Facility‐Based Childbirth in North Showa Zone, Ethiopia

“…Freedom from detention is the right of each childbearing woman and a woman or her baby should never be forcibly kept in a facility. Detention is the least reported category by participants, and this is similar to rates reported in other studies from Ethiopia (21,23,25,29,(31)(32)(33) possibly because, maternity services are free of charge in Ethiopia and detention due to unaffordable service bills are rare. The economic status of women has been identi ed as a signi cant barrier to quality care.…”

“…Previous studies have identi ed that working in under-equipped and overwrought health systems affects provider enthusiasm and is often labelled as signi cant contributor to D&A in facilities (50). Local studies have similarly reported higher incidence of D&A among women who gave birth at hospitals (21,24,25,30,32).…”

“…Research shows growing evidence of disrespectful and abusive care in Ethiopia (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Thus, understanding D&A will help inform changes in the practice and culture of maternity care.…”

Disrespect and Abuse during Childbirth in Ethiopia: A Systematic Review

“…Nine of the included studies were performed simultaneously in both rural-urban settings [ 31 , 35 – 42 ], eleven in urban setting [ 14 , 33 , 34 , 43 – 51 ] and one in rural setting [ 32 ]. Three of the studies were conducted in the capital (Addis Ababa) [ 33 , 43 , 46 ], two in Tigray region [ 42 , 47 ], four in Amhara region [ 14 , 34 , 44 , 49 ], five in Oromia region [ 36 , 37 , 39 , 50 , 51 ], three in SNNP region [ 38 , 40 , 45 ], two in both SNNP and Amhara regions [ 32 , 35 ], one in four of the regions (Tigray, Oromia, SNNP and Amhara) [ 41 ], and one was done nationwide of rural settings [ 31 ] ( Table 1 ).…”

“…Prevalence studies in Ethiopia have shown prevalence reports revealed that women experience at least one form of disrespect and abuse during childbirth ranging from 21.1% [ 32 ] to 98.9% [ 45 ], which are unacceptably high levels of obstetric violence and mistreatment care.…”