The prevalence of respectful maternity care during childbirth and its determinants in Ethiopia: A systematic review and meta-analysis

Abstract

Background Respectful maternity care is the provision of woman-centered health care during childbirth that is friendly, abuse-free, timely, and discrimination-free. Although several epidemiological studies on the magnitude and determinants of Respectful maternity care in Ethiopia have been conducted, the results have been inconsistent and varied. This makes drawing equivocal conclusions and evidence at the national level harder. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of respectful maternity care and its determinants in Ethiopia. Methods Studies conducted from 2013 to June 30, 2022, were searched by using PubMed, Google Scholar, Science Direct, Scopus, ProQuest, Web of Science, Cochrane Library, and Direct of Open Access Journals. Searching was carried out from May 15- June 30, 2022. In total, sixteen studies were considered in the final analysis. The data were extracted using Microsoft Excel and analyzed using STATA 16 software. The methodological quality of included studies was assessed by using Joanna Briggs Institute’s critical appraisal checklist for prevalence studies. To estimate the pooled national prevalence of respectful maternity care, a random effect model with a DerSimonian Laird method was used. To assess the heterogeneity of the included studies, the Cochrane Q test statistics and I2 tests were used. To detect the presence of publication bias, a funnel plot and Begg’s and Egger’s tests were used. Results Sixteen studies were eligible for this systematic review and meta-analysis with a total of 6354 study participants. The overall pooled prevalence of respectful maternity care in Ethiopia was 48.44% (95% CI: 39.02–57.87). Receiving service by CRC-trained health care providers [AOR: 4.09, 95% CI: 1.73, 6.44], having ANC visits [AOR: 2.34, 95% CI: 1.62, 3.06], planning status of the pregnancy [AOR = 4.43, 95% CI: 2.74, 6.12], giving birth during the daytime [AOR: 2.61, 95% CI: 1.92, 3.31], and experiencing an obstetric complication[AOR: 0.46, 95% CI: 0.30, 0.61] were identified as determinants of RMC. Conclusion As per this meta-analysis, the prevalence of respectful maternity care in Ethiopia was low. Managers in the health sector should give due emphasis to the provision of Compassionate, Respectful, and Care(CRC) training for healthcare providers, who work at maternity service delivery points. Stakeholders need to work to increase the uptake of prenatal care to improve client-provider relationships across a continuum of care. Human resource managers should assign an adequate number of health care providers to the night-shift duties to reduce the workload on obstetric providers.

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“…In line with this our study also reviled that lack of respectful care is another barrier for service utilization. Providing abusive care might be liked to lack of trained staff which is in line with our study and this finding is also in line with other studies done in other parts of Ethiopia( 28 , 29 ).…”

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“…Furthermore, the expansion of the urban Health extension professional and addition of level IV Health extension workers in rural set up should be used as a stepping stone to improve the provision and completion of care for maternal and newborn care continuum (27) at community level thereby enabling women to get informed counseling about their role of husband and/or partner encouragement and involvement at maternal and new born care continuum enrollment thereby improving continuum of maternal and new born care. Moreover, the government’s effort to improve quality of maternal and child health care and respectful maternity care (28) along with the continuum of care is likely to encourage women to plan their pregnancies and subsequently to be to be encouraged by their husband and/or partner and the variation in community support for pregnant and postpartum women to utilize the three domains of the maternal and new born continuum of care packages also contributes for this observed variation in the partner dynamics: Community based 2 year Cohort follow up Study (29) as well as lack of partner encouragement that his wife to clinic for ANC, discuss where to deliver and seek postnatal care for the index pregnancy as reported by a study (30) entitled “”The impact of partner autonomy constraints on women’s health-seeking across the maternal and newborn continuum of care.”” : the fact that nearly one in 5 (18.2%; 16.64%, 20.33%) women reported that their husband and/or partner not encourage to go to clinic for ANC and is in line with a study (30).…”