Respectful family planning service provision in Sidama zone, Southern Ethiopia

Abstract

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.