Healthcare providers’ perspectives of disrespect and abuse in maternity care facilities in Nigeria: a qualitative study

Abstract

ObjectivesTo explore healthcare providers’ perspectives of disrespect and abuse in maternity care and the impact on women’s health and well-being. MethodsQualitative interpretive approach using in-depth semi-structured interviews with sixteen healthcare providers in two public health facilities in Nigeria. Interviews were audio-recorded, transcribed, and analysed thematically.ResultsHealthcare providers’ accounts revealed awareness of what respectful maternity care encompassed in accordance with the existing guidelines. They considered disrespectful and abusive practices perpetrated or witnessed as violation of human rights, while highlighting women’s expectations of care as the basis for subjectivity of experiences. They perceived some practices as well-intended to ensure safety of mother and baby. Views reflected underlying gender-related notions and societal perceptions of women being considered weaker than men. There was recognition about adverse effects of disrespect and abuse including its impact on women, babies, and providers’ job satisfaction.ConclusionsHealthcare providers need training on how to incorporate elements of respectful maternity care into practice including skills for rapport building and counselling. Women and family members should be educated about right to respectful care empowering them to report disrespectful practices.

The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal

“…Prior to COVID-19, our study shows that some hospitals were already overburdened with large volumes of births and overcrowding, in some cases with nearly 200% BOR rates and with one health worker delivering an average of 1000 women per year. The association between overcrowding and poor provision and experience of care has been argued by others in Nepal [ 43 ] and elsewhere [ 44 , 45 ], and is reinforced by our study. Before the pandemic, by-passing of the primary referral health facilities (low-volume) was already a challenge in Nepal leading to overcrowding at the higher level facilities (medium-and high-volume) [ 32 , 44 , 46 ].…”

Enablers and Barriers to Respectful Maternity Care in Low and Middle-Income Countries: A Literature Review of Qualitative Research

“…Healthcare staff narrated that for them to provide RMC, the rural un-educated pregnant women should be provided with the required information during antenatal visit, also involve them in care decisions as it eases stress of explanations during delivery and subsequent care [35] [42] [50] [51] [79].…”

Discriminação racial e saúde: ações dos profissionais de saúde na assistência à mulher em processo de abortamento provocado

“…Na análise da assistência por profissionais de saúde, a percepção dos sujeitos sobre o aborto provocado e das mulheres enquanto potenciais mães se somam aos sentidos atribuídos ao hospital-maternidade para influenciar negativamente a qualidade do atendimento, levando à objetificação das mulheres em abortamento 45 . De modo geral, o conjunto de profissionais ao serem questionados acerca dos possíveis motivos que levam as mulheres a engravidar e abortar, sem distinção de categoria ocupacional, descreve as usuárias que induziram o aborto, incluindo uma ou mais das seguintes características: negras, precárias condições financeiras, baixa escolaridade, instabilidade do laço conjugal, abandono do parceiro, falta de apoio familiar, irresponsáveis e de sexualidade desenfreada 38,39,44,47,48,51,52 .…”

“…Estas últimas são desqualificadas 24,29 , sendo atribuído um estado de anormalidade psíquica ao praticarem um aborto. Os resultados expressam indícios de que as instituições de saúde e os profissionais desses hospitais abarcam em suas práticas a violência institucional 38,40,41,43,49,53 , sobretudo com práticas desumanizantes de atenção 51,52 e violência simbólica 52 . Ademais, a não priorização do atendimento às mulheres com abortamento é evidente na pouca atenção dada a estas usuárias, e a existência de discriminação racial.…”

“…Ademais, a não priorização do atendimento às mulheres com abortamento é evidente na pouca atenção dada a estas usuárias, e a existência de discriminação racial. São identificados nos artigos as precárias condições das unidades de saúde, deficiências da infraestrutura dos serviços, com superlotação das maternidades 44,47,[51][52][53][54] .…”