Lifting the veil on disrespect and abuse in facility-based child birth care: findings from South West Nigeria

Abstract

BackgroundEliminating disrespect and abuse in health care facilities during childbirth could be a contributory factor in improving pregnancy outcomes and avoiding preventable illnesses and deaths. This study aims to provide evidence of disrespect and abuse in this community in order to create awareness about its occurrence.MethodsA cross-sectional survey was carried out on 384 recently delivered women who visited the postnatal and immunization clinics of a primary and tertiary health facility in Ile-Ife. Information was sought about awareness of disrespect and abuse, prevalence and forms of disrespect and abuse, and opinions on improvements which can be made in maternity services. Univariate analysis was used to summarise the data.ResultsAbout half of the respondents were in their fourth decade of life and had tertiary education. Overall, the majority (98.4%) of respondents agreed that it was their right to be treated with respect and dignity during childbirth while about one-fifth (19%) had ever experienced some form of disrespect and abuse. The commonly identified forms of disrespect and abuse were: non-dignified care (12.8%), discrimination (8.1%), a detention and abandonment (6%). However, the majority (81%) of the respondents did not have any suggestions for improvements in delivery services.ConclusionsAlthough most of the respondents knew it was their right to be treated with respect, some reported that they had experienced disrespect and abuse during childbirth in varying forms. The evidence from this survey draws attention to the need for interventions to address the health system factors hindering health service utilization.

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

“…Our findings are comparable to evidence from previous studies [1,6,10,11]. Although, most women in this study were treated with respect, as much as 20% were verbally abused, which is slightly higher than findings of 11-18% in prior studies [6,10,11], but consistent with high incidence of disrespect and abuse in other studies [12][13][14][15][16][17][18][19]. Similarly, our finding that 7% of women were physically abused was higher than results elsewhere [6,10,11,15], but lower than findings reported in previous studies [12,[16][17][18].…”

“…Although, most women in this study were treated with respect, as much as 20% were verbally abused, which is slightly higher than findings of 11-18% in prior studies [6,10,11], but consistent with high incidence of disrespect and abuse in other studies [12][13][14][15][16][17][18][19]. Similarly, our finding that 7% of women were physically abused was higher than results elsewhere [6,10,11,15], but lower than findings reported in previous studies [12,[16][17][18]. The sharp decrease in physical abuse might reflect underreporting as this behaviour may be accepted as normal and not considered as abuse or disrespect by some women in Nigeria [16], or due to a rising awareness of litigation among care providers [15].…”

“…Overall, 11-40% of women were treated with respect few times or never; 14-39% received friendly treatment few times or never; 11-18% were verbally abused at least once; 2-4% reported physically abuse; 11-47% did not receive adequate visual privacy; and 15-38% felt their health records were kept confidential few times or never [6,10,11]. Other studies found 19-98% prevalence of disrespect and abuse among women during childbirth in health facilities [12][13][14][15][16][17][18][19]. About 87-98% of women reported limited introduction of self by providers; 47-69% reported providers did not often call them by names; 17-77% were poorly involved in their care; 50-87% received unconsented procedures; 29-82% received poor explanation of medicines; and 36-74% felt unable to ask providers questions [6,10,11].…”

The Proportion and Nature of Disrespect and Abuse during facility-based care in a rural and an urban setting in Kano, northwest Nigeria; A mixed-method study

“…All three regions of the previous studies were however done in urban settings alone. Evidence from a recent study in another south west state showed a low rate of about 19% and various interventions are likely to reduce D&A where the rates are already high [24]. The present study showed D&A were as high as 75.3% in urban settings unlike 18.3% obtained in rural settings.…”

“…These are similar to findings of Amole et al who reported that most of the respondents were 25-29years with average age of 27.7 ± 6.3, mostly married, housewives, of Hausa ethnic group, but rather a secondary level of education as their respondents were only urban Kano women [17]. The finding defers from those of a study from the South-west Nigeria where more than half of the respondents were in the 30-39 year age group, another half had a tertiary education and of Yoruba ethnic group [24] or another from the south east where mean age of the respondents was 32.1 ± 2.7 years, mainly from the Igbo tribe and more than one third had completed tertiary education [18].…”