Exposure to disrespectful patient care during training: Data from midwifery students at 15 midwifery schools in Ghana

Moyer, Cheryl A.; Rominski, Sarah; Nakua, Emmanuel Kweku; Dzomeku, Veronica Millicent; Agyei‐Baffour, Peter; Lori, Jody R.

doi:10.1016/j.midw.2016.07.009

Cited by 45 publications

(58 citation statements)

References 19 publications

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“…Women corroborated these views, and believed that mistreatment occurred because health workers were poorly trained and overworked [12]. Similarly, Rominski and colleagues and Moyer and colleagues highlight that mistreatment during childbirth is engrained in the health system, beginning during midwifery training where trainees are exposed to mistreatment and a lack of accountability for such actions [10, 11]. …”

Section: Discussionmentioning

confidence: 99%

A qualitative study of women’s and health providers’ attitudes and acceptability of mistreatment during childbirth in health facilities in Guinea

et al. 2017

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BackgroundReducing maternal morbidity and mortality remains a key health challenge in Guinea. Anecdotal evidence suggests that women in Guinea are subjected to mistreatment during childbirth in health facilities, but limited research exists on this topic. This study was conducted to better understand the social norms and the acceptability of four scenarios of mistreatment during childbirth, from the perspectives of women and service providers.MethodsThis study used qualitative methods including in-depth interviews (IDIs) and focus group discussions (FGDs) with women of reproductive age, midwives, nurses and doctors. This study was conducted in one urban area (Mamou) and one peri-urban area (Pita) in Guinea. Participants were presented with four scenarios of mistreatment during childbirth, including a provider: (1) slapping a woman; (2) verbally abusing a woman; (3) refusing to help a woman; and (4) forcing a woman to give birth on the floor. Data were collected in local languages (Pular and Malinké) and French, and transcribed and analyzed in French. We used a thematic analysis approach and manually coded the data using a codebook developed for the project.ResultsA total of 40 IDIs and eight FGDs were conducted with women of reproductive age, 5 IDIs with doctors, and 13 IDIs with midwives. Most women were not accepting of any of the scenarios, unless the action was perceived to be used to save the life of the mother or child. However, they perceived a woman’s disobedience and uncooperativeness to contribute to her poor treatment. Women reacted to this mistreatment by accepting poor treatment, refusal to use the same hospital, revenge against the provider or complaints to hospital management. Service providers were accepting of mistreatment when women were disobedient, uncooperative, or to save the life of the baby.ConclusionsThis is the first known study on mistreatment of women during childbirth to be conducted in Guinea. Both women and service providers were accepting of mistreatment during childbirth under certain conditions. Any approach to preventing and eliminating mistreatment during childbirth must consider these important contextual and social norms and develop a comprehensive intervention that addresses root causes. Further research is needed on how to measure mistreatment during childbirth in Guinea.

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Section: Discussionmentioning

confidence: 99%

A qualitative study of women’s and health providers’ attitudes and acceptability of mistreatment during childbirth in health facilities in Guinea

et al. 2017

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“…The independent variables were place of origin (urban, rural), age, observation of mistreatment during education, self-esteem, and stress. To assess observation of mistreatment during education (α = 0.70), we used ten items of a questionnaire by Moyer et al [17]. Students had to indicate on a scale, including: 1 (never), 2 (rarely), 3 (sometimes), and 4 (most of the time), whether they had observed disrespectful maternity care during their education thus far.…”

Section: Methodsmentioning

confidence: 99%

“…Previous literature on mistreatment during childbirth and individual level risk factors among care providers is limited, yet some characteristics have been outlined, such as young age, observation of mistreatment during education, low self-esteem, and high stress levels [6,[15][16][17][18]. It is important to acknowledge that these findings stem from different countries and sample populations, where not all factors might play a role in each setting.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Positive Appraisal of Mistreatment during Childbirth among Ethiopian Midwifery Students

Bakker

Sheferaw

Yigzaw³

et al. 2020

IJERPH

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The maternal mortality ratio and neonatal mortality rate remain high in Ethiopia, where few births are attended by qualified healthcare staff. This is partly due to care providers’ mistreatment of women during childbirth, which creates a culture of anxiety that decreases the use of healthcare services. This study employed a cross-sectional design to identify risk factors for positive appraisal of mistreatment during childbirth. We asked 391 Ethiopian final year midwifery students to complete a paper-and-pen questionnaire assessing background characteristics, prior observation of mistreatment during education, self-esteem, stress, and mistreatment appraisal. A multivariable linear regression analysis indicated age (p = 0.005), stress (p = 0.019), and previous observation of mistreatment during education (p < 0.001) to be significantly associated with mistreatment appraisal. Younger students, stressed students, and students that had observed more mistreatment during their education reported more positive mistreatment appraisal. No significant association was observed for origin (p = 0.373) and self-esteem (p = 0.445). Findings can be utilized to develop educational interventions that counteract mistreatment during childbirth in the Ethiopian context.

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“…There are many evidence based definitions of disrespectful maternity care (2)(3)(4)(5)(6)(7)(8). The most commonly used definition is identified by Bowser and Hill (2010), which includes physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination, abandonment of care and detention in health facility (6,(9)(10)(11)(12)(13)(14). Disrespect and abuse of service seeking women is an urgent problem that needs the concern of all stake holders including health care research, quality and education, human rights and civil rights advocacy throughout the entire world (4).…”

Section: Introductionmentioning

confidence: 99%

Respectful family planning service provision in Sidama zone, Southern Ethiopia

Siyoum

Astatkie

Melese

et al. 2019

Preprint

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Introduction Disrespect and abusive care is a violation of women’s basic human rights and it is serious global problem that needs urgent intervention. In Ethiopia disrespect and abusive care is very common (21-78%) across health facilities. Objective To assess the status of respectful family planning service in Sidama zone, south Ethiopia. Methodology Health facility-based cross-sectional study was conducted from June to August 2018. Data were collected from 920 family planning clients’ recruited from 40 randomly selected health facilities. The Mother on Respect index (MORi) questionnaire was used to collect the data through client exit interview. Partial proportional odds ordinal regression was employed to identify determinants of respectful family planning service. Result The level of respectful family planning service was found to be: Zero (0%) in the very low respect category, 75(18.5%) low respect, 382(41.52%) moderate respect and 463(50.33%) high respect. Being a short acting method client (AOR=0.3, 95%CI [0.12, 0.72]), participants’ level of education (uneducated (AOR=0.39, 95%CI [0.25, 0.61), elementary (AOR=0.41, 95%CI [0.23, 0.73]), low income(AOR=0.75, 95%CI [0.56, 0.99]), long waiting time (AOR=0.46, 95%CI [0.30, 0.69]), were negatively associated with moderate and high respect compared to low respect. Preference of male service providers (AOR=2, 95%CI [1.1, 3.8]), service providers’ work satisfaction (AOR=1.55, 95%CI [1.13, 2.14]) and health workers’ prior training on respectful care (AOR=8.75, 95%CI [4.61, 16.61]) were positively associated. Being a client of short acting contraceptives (AOR=2.1, 95%CI [1.42, 3.12]), preference of male service providers (AOR=0.55, 95%CI [0.4, 0.76]) and health workers’ prior training on respectful care (AOR=3.03, 95%CI [2.24, 4.1]) had significant association with high respect compared to low and moderate respect. Conclusion Considering the current strategy of zero tolerance for disrespect in Ethiopia, the level of respectful care in this study is sub-optimal. We recommend community awareness and short term training for service providers.

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Exposure to disrespectful patient care during training: Data from midwifery students at 15 midwifery schools in Ghana

Cited by 45 publications

References 19 publications

A qualitative study of women’s and health providers’ attitudes and acceptability of mistreatment during childbirth in health facilities in Guinea

A qualitative study of women’s and health providers’ attitudes and acceptability of mistreatment during childbirth in health facilities in Guinea

Risk Factors for Positive Appraisal of Mistreatment during Childbirth among Ethiopian Midwifery Students

Respectful family planning service provision in Sidama zone, Southern Ethiopia

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