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What factors are associated with forms of mistreatment during facility-based childbirth? A survey of referral health facilities in south-east Nigeria

Published online by Cambridge University Press:  13 September 2021

Ijeoma Nkem Okedo-Alex Open the ORCID record for Ijeoma Nkem Okedo-Alex [Opens in a new window] ,
Ifeyinwa Chizoba Akamike ,
Ugonna Igwilo  and
Chika Nwakanma Onwasigwe
Ijeoma Nkem Okedo-Alex*
Affiliation:
Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
Ifeyinwa Chizoba Akamike
Affiliation:
Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
Ugonna Igwilo
Affiliation:
Department of Community Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
Chika Nwakanma Onwasigwe
Affiliation:
Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
*
*Corresponding author. Email: [email protected]
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Abstract

Mistreatment during childbirth in health facilities contributes significantly to suboptimal levels of skilled birth attendance. This study determined the factors associated with mistreatment during facility-based childbirth in two referral facilities in south-east Nigeria. A survey of 620 women whose childbirth occurred in two high-patronage referral hospitals of Ebonyi, Nigeria, was conducted in July–September 2018 using interviewer-administered questionnaires. Data analysis was performed using SPSS version 20. Logistic regression was used to identify predictors. The mean age of the respondents was 29.86 ± 4.4 years. Most had post-secondary education (71.0%), and had attended at least four antenatal visits (83.4%). The prevalence of any mistreatment during childbirth was 56%. Rural residence (adjusted odds ratio [AOR]: 0.53; CI: 0.35, 0.78, p = 0.002) and childbirth facilitated by a doctor (AOR: 1.7; CI: 1.14, 2.39, p = 0.007) were predictors of reporting at least one form of mistreatment during childbirth. Childbirth facilitated by a doctor (AOR: 1.66; CI: 1.05, 2.63, p = 0.031) and unemployment (AOR: 1.84; CI: 1.01, 3.07, p = 0.011) increased the odds of non-consented and non-dignified care, respectively. Rural residence (AOR: 0.57; CI: 0.37, 0.88, p = 0.011) and childbirth facilitated by a doctor (AOR: 0.65; CI: 0.45, 0.94, p = 0.020) were protective against abandonment/neglect. Vaginal birth (AOR: 0.33; CI: 0.16, 0.69, p = 0.003) reduced the odds of detention in the health facility following childbirth. Almost three-fifths of the women whose childbirths occurred in the surveyed facilities experienced at least one form of mistreatment during childbirth. Place of residence, health professional type, mode of childbirth, employment status and frequency of antenatal attendance were predictors of mistreatment during childbirth. Rights-based sensitization for women, especially in the rural areas, female empowerment, provider capacity-building on respectful client care and provision of subsidized maternal health services are recommended.

Keywords

Respectful maternity careMistreatment during childbirthFacility-based childbirth
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 5 , September 2022 , pp. 776 - 791
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Abuya, T, Ndwiga, C, Ritter, J, Kanya, L, Bellows, B, Binkin, N and Warren, CE (2015a) The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya. BMC Pregnancy and Childbirth 15, 224.Google ScholarPubMed
Abuya, T, Warren, C, Bellows, B, Abuya, T, Warren, CE, Miller, N et al. (2015b) Exploring the prevalence of disrespect and abuse during childbirth in Kenya. PloS One 10(4), e0123606.CrossRefGoogle ScholarPubMed
Anyait, A, Mukanga, D, Oundo, GB and Nuwaha, F (2012) Predictors for health facility delivery in Busia district of Uganda: a cross sectional study. BMC Pregnancy and Childbirth 12(1), 1.CrossRefGoogle ScholarPubMed
Araoye, MO (2004) Research Methodology with Statistics for Health and Social Sciences. 1st edition. Nathadex Publishers.Google Scholar
Azhar, Z, Oyebode, O and Masud, H (2017) Disrespect and abuse during childbirth in district Gujrat, Pakistan: a quest for respectful maternity care. Annals of Global Health 83(1), 108.CrossRefGoogle Scholar
Bhattacharyya, S, Srivastava, A and Avan, BI (2013) Delivery should happen soon and my pain will be reduced: understanding women’s perception of good delivery care in India. Global Health Action 6(22635), e22635.CrossRefGoogle Scholar
Bohren, MA, Mehrtash, H, Fawole, B, Maung, TM, Balde, MD, Maya, E et al. (2019) How women are treated during facility-based childbirth in four countries: a cross-sectional study with labour observations and community-based surveys. The Lancet 394(10210), 1750–1763.CrossRefGoogle ScholarPubMed
Bohren, MA, Vogel, JP, Hunter, EC, Lutsiv, O, Makh, SK, Diniz, A et al. (2015) The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Medicine 12(6), 1–32.CrossRefGoogle ScholarPubMed
Bowser, D and Hill, K (2010) Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth: Report of a Landscape Analysis. URL: http://www.urc-chs.com/uploads/resourceFiles/Live/Respectful CareatBirth9-20-101Final.pdf (accessed 5th February 2018).Google Scholar
College of the Holy Cross (2017) Catholics by Country – Nigeria. Catholics and Cultures. URL: https://www.catholicsandcultures.org/nigeria (accessed 15th February 2021).Google Scholar
Denscombe, M (2010) The Good Research Guide for Small Scale Social Research Project. 4th edition. Open University Press.Google Scholar
Ebonyi State Ministry of Health (2010) Ebonyi State Government Strategic Health Development Plan. URL: https://ngfrepository.org.ng:8443/handle/123456789/3241 (accessed 6th February 2018).Google Scholar
Freedman, L and Kruk, M (2014) Disrespect and abuse of women in childbirth: challenging the global quality and accountability agendas. The Lancet 384(9948), e42–e44.CrossRefGoogle ScholarPubMed
Freedman, LP, Ramsey, K, Abuya, T, Bellows, B, Ndwiga, C, Warren, CE et al. (2014) Defining disrespect and abuse of women in childbirth: a research, policy and rights agenda. Buletin of the World Health Organization 92, 915–917.CrossRefGoogle ScholarPubMed
Lachenbruch, PA, Lwanga, SK and Lemeshow, S (1991) Sample size determination in health studies: a practical manual. Journal of the American Statistical Association 86(416), 1149.CrossRefGoogle Scholar
Madhiwalla, N, Ghoshal, R, Mavani, P and Roy, N (2018) Identifying disrespect and abuse in organisational culture: a study of two hospitals in Mumbai, India. Reproductive Health Matters 26(53), 36–47.CrossRefGoogle ScholarPubMed
Moyer, CA, Adongo, PB, Aborigo, RA, Hodgson, A and Engmann, CM (2014) ‘They treat you like you are not a human being’: maltreatment during labour and delivery in rural northern Ghana. Midwifery 30(2), 262–268.CrossRefGoogle Scholar
National Population Commission (2006) Population and Housing Census of the Federal Republic of Nigeria Volume I. URL: http://www.population.gov.ng/indexphp/publications (accessed 13th February 2021).Google Scholar
Nwaze, I (2002) A Practical Guide to Research in the Field of Health and Biostatistics. 1st edition. Guzan Publishers.Google Scholar
Okafor, II, Ugwu, EO and Obi, SN (2015) Disrespect and abuse during facility-based childbirth in a low-income country. International Journal of Gynecology and Obstetrics 128(2), 110–113.CrossRefGoogle Scholar
Okedo-Alex, IN, Akamike, IC, Nwafor, JI, Abateneh, DD and Uneke, CJ (2020) Multi-stakeholder perspectives on the maternal, provider, institutional, community, and policy drivers of disrespectful maternity care in South-East Nigeria. International Journal of Women’s Health 12, 1145–1159.CrossRefGoogle ScholarPubMed
Okedo-Alex, IN, Akamike, IC and Okafor, LC (2020) Does it happen and why? Lived and shared experiences of mistreatment and respectful care during childbirth among maternal health providers in a tertiary hospital in Nigeria. Women and Birth, doi: org/doi: 10.1016/j.wombi.2020.09.015CrossRefGoogle Scholar
Pulchalski, C (2001) The role of spirituality in health care. Proceedings of the Baylor University Medical Center 14(4), 352–357.CrossRefGoogle Scholar
Raj, A, Dey, A, Boyce, S, Seth, A, Bora, S, Chandurkar, D et al. (2017) Associations between mistreatment by a provider during childbirth and maternal health complications in Uttar Pradesh, India. Maternal and Child Health Journal 21(9), 1821–1833.CrossRefGoogle ScholarPubMed
Ratcliffe, HL, Sando, D, Lyatuu, GW, Emil, F, Mwanyika-Sando, M, Chalamilla, G et al. (2016) Mitigating disrespect and abuse during childbirth in Tanzania: an exploratory study of the effects of two facility-based interventions in a large public hospital. Reproductive Health 13, 39.CrossRefGoogle Scholar
Sando, D, Abuya, T, Asefa, A, Banks, KP, Freedman, LP, Kujawski, S et al. (2017) Methods used in prevalence studies of disrespect and abuse during facility based childbirth: lessons learned. Reproductive Health 14, 127.CrossRefGoogle ScholarPubMed
Sando, D, Kendall, T, Lyatuu, G, Ratcliffe, H, McDonald, K, Mwanyika-Sando, M et al. (2014). Disrespect and abuse during childbirth in Tanzania: are women living with HIV more vulnerable? Journal of Acquired Immune Deficiency Syndrome 67(4), 228–234.CrossRefGoogle ScholarPubMed
Sethi, R, Gupta, S, Oseni, L, Mtimuni, A, Rashidi, T and Kachale, F (2017) The prevalence of disrespect and abuse during facility-based maternity care in Malawi: evidence from direct observations of labor and delivery. Reproductive Health 14(1), 111.CrossRefGoogle ScholarPubMed
Sheferaw, ED, Bazant, E, Gibson, H, Fenta, HB, Ayalew, F, Belay, TB et al. (2017) Respectful maternity care in Ethiopian public health facilities. Reproductive Health 14(60), 1–12.CrossRefGoogle ScholarPubMed
StataCorp (2011) Stata Statistical Software: Release 12. StataCorp LP.Google Scholar
Sudhinaraset, M, Treleaven, E, Melo, J, Singh, K and Diamond-Smith, N (2016) Women’s status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory. BMC Pregnancy and Childbirth 26(332), doi: 10.1186/s12884-016-1124-4 Google Scholar
Tunçalp, Ö, Were, W, MacLennan, C, Oladapo, O, Gülmezoglu, A, Bahl, R et al. (2015) Quality of care for pregnant women and newborns – the WHO vision. BJOG 122(8), 1045–1049.CrossRefGoogle ScholarPubMed
United Nations (2013) The Millennium Development Goals Report 2013. URL: http://www.un.org/milleniumgoals/pdf/report-2013/mdg-report-2013-english.pdf (accessed 15th November 2020).Google Scholar
Ushie, BA, Udoh, EE and Ajayi, AI (2019) Examining inequalities in access to delivery by caesarean section in Nigeria. Plos One 14(8), e0221778.CrossRefGoogle ScholarPubMed
Uzochukwu, BS and Onwujekwe, OE (2004) Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. International Journal for Equity in Health 3, 6.Google ScholarPubMed
Vogel, JP, Bohren, MA, Tunçalp, O, Oladapo, OT and Gülmezoglu, AM (2016) Promoting respect and preventing mistreatment during childbirth. BJOG 123(5), 671–674.CrossRefGoogle ScholarPubMed
Wassihun, B, Deribe, L, Worede, N and Gultie, T (2018) Prevalence of disrespect and abuse of women during child birth and associated factors in Bahir Dar town, Ethiopia. Epidemiology and Health 40, e2018029.CrossRefGoogle ScholarPubMed
White Ribbon Alliance (2010) Respectful Maternity Care: The Universal Rights of Childbearing Women. URL: https://www.whiteribbonalliance.org/respectfulcare (accessed 13th October 2020).Google Scholar
World Health Organization (2014) The Prevention and Elimination of Disrespect and Abuse During Facility-Based Childbirth: WHO Statement. URL: https://apps.who.int/iris/bitstream/10665/134588/1/WHO_RHR_14.23_eng.pdf?ua=1&ua=1 (accessed 13th October 2020).Google Scholar
World Health Organization (2015) Maternal Mortality Fact Sheet. URL: https://www.who.int/reproductivehealth (accessed 23rd February 2021).Google Scholar
World Health Organization (2018) Maternal Mortality Fact Sheets. URL: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality (accessed 23rd February 2021).Google Scholar