Methods used in prevalence studies of disrespect and abuse during facility based childbirth: lessons learned

Abstract

BackgroundSeveral recent studies have attempted to measure the prevalence of disrespect and abuse (D&A) of women during childbirth in health facilities. Variations in reported prevalence may be associated with differences in study instruments and data collection methods. This systematic review and comparative analysis of methods aims to aggregate and present lessons learned from published studies that quantified the prevalence of Disrespect and Abuse (D&A) during childbirth.MethodsWe conducted a systematic review of the literature in accordance with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Five papers met criteria and were included for analysis. We developed an analytical framework depicting the basic elements of epidemiological methodology in prevalence studies and a table of common types of systematic error associated with each of them. We performed a head-to-head comparison of study methods for all five papers. Using these tools, an independent reviewer provided an analysis of the potential for systematic error in the reported prevalence estimates.ResultsSampling techniques, eligibility criteria, categories of D&A selected for study, operational definitions of D&A, summary measures of D&A, and the mode, timing, and setting of data collection all varied in the five studies included in the review. These variations present opportunities for the introduction of biases – in particular selection, courtesy, and recall bias – and challenge the ability to draw comparisons across the studies’ results.ConclusionOur review underscores the need for caution in interpreting or comparing previously reported prevalence estimates of D&A during facility-based childbirth. The lack of standardized definitions, instruments, and study methods used to date in studies designed to quantify D&A in childbirth facilities introduced the potential for systematic error in reported prevalence estimates, and affected their generalizability and comparability. Chief among the lessons to emerge from comparing methods for measuring the prevalence of D&A is recognition of the tension between seeking prevalence measures that are reliable and generalizable, and attempting to avoid loss of validity in the context where the issue is being studied.Electronic supplementary materialThe online version of this article (10.1186/s12978-017-0389-z) contains supplementary material, which is available to authorized users.

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

“…On the contrary, one non-comparative cross-sectional study has reported that respondents from a rural setting are more likely to complain of D&A [26]. It is also important to note that studies document a wide range of estimates due to different methodological approaches, including varying operational definitions of the construct of interest [23].…”

“…The study adopted a quantitative data collection utilizing questionnaire and qualitative data collection by utilizing in-depth interviews (IDIs) for health workers and focus group discussions (FGDs) for recently delivered women. It was a hospital-based survey which took place in the postnatal and immunization clinic and involved women of reproductive age (15-49years) in the selected communities who delivered their babies in the health facility within the past 1year (7,(17)(18)(19)(20)(21)(22)(23).…”

Development and Validation of the Client‐Reported Quality of Contraceptive Counseling Scale to Measure Quality and Fulfillment of Rights in Family Planning Programs

“…; Sando et al. )—would help align measurement tools with the new focus on rights‐based service delivery. Finally, existing measurement tools have not been assessed psychometrically for reliability and validity across settings (i.e., the extent to which they provide precise, unbiased measurement of clients’ experiences with counseling in different settings is unknown).…”

Obstetric violence: a Latin American legal response to mistreatment during childbirth

“…These laws offer a potentially promising approach to responding to obstetric mistreatment, a phenomenon that appears to be pervasive across many settings. Though the exact prevalence of treatment that would qualify as obstetric mistreatment is unknown, studies from Tanzania and Brazil report figures >70% whereas figures from five European countries are around 20% . This suggests that the prevalence may be widespread and that obstetric violence may present challenges to guaranteeing quality maternal care in a variety of different contexts.…”