Mistreatment of women in public health facilities of Ethiopia

Ephrem D. Sheferaw; Young Mi Kim; Thomas Van Den Akker; Jelle Stekelenburg

doi:10.1186/s12978-019-0781-y

Mistreatment of women in public health facilities of Ethiopia

Ephrem D. Sheferaw^*, Young Mi Kim, Thomas Van Den Akker, Jelle Stekelenburg

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors. Methods: A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling. Results: A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028). Conclusion: Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.

Original language	English
Article number	130
Journal	Reproductive Health
Volume	16
Issue number	1
DOIs	https://doi.org/10.1186/s12978-019-0781-y
Publication status	Published - 27 Aug 2019
Externally published	Yes

Funding

aOR: Adjusted Odds Ratio; BEmONC: Basic Emergency Obstetrics and Newborn Care; CI: Confidence Interval; D&A: Disrespect and Abuse; DE: Design Effect; MCSP: Maternal and Child Survival Program; MMR: Maternal Mortality Ratio; MNH: Maternal and Newborn Health; MOH: Ministry of Health; OR: Odds Ratio; RMC: Respectful Maternity Care; SNNPR: Southern Nation Nationalities Peoples Region; USAID: United States Agency for International Development The authors would like to acknowledge the support of colleagues from Jhpiego and Ministry of health during data collection. Finally, we would like to acknowledge the contribution of data collectors’ and women who took their time to share their experience for the study team. This research was funded by USAID through Maternal and Child Survival Program under the terms of the Cooperative Agreement AID-OAA-A-14 -00028.

Keywords

Disrespect and abuse
Ethiopia
Mistreatment
Respectful maternity care

Access to Document

10.1186/s12978-019-0781-y

Persistent URL (handle)

Persistent link

Cite this

@article{668cb0a918e0416b907160e3e37d0274,

title = "Mistreatment of women in public health facilities of Ethiopia",

abstract = "Background: Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors. Methods: A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling. Results: A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028). Conclusion: Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.",

keywords = "Disrespect and abuse, Ethiopia, Mistreatment, Respectful maternity care",

author = "Sheferaw, {Ephrem D.} and Kim, {Young Mi} and {Van Den Akker}, Thomas and Jelle Stekelenburg",

year = "2019",

month = aug,

day = "27",

doi = "10.1186/s12978-019-0781-y",

language = "English",

volume = "16",

journal = "Reproductive Health",

issn = "1742-4755",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Mistreatment of women in public health facilities of Ethiopia

AU - Sheferaw, Ephrem D.

AU - Kim, Young Mi

AU - Van Den Akker, Thomas

AU - Stekelenburg, Jelle

PY - 2019/8/27

Y1 - 2019/8/27

N2 - Background: Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors. Methods: A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling. Results: A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028). Conclusion: Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.

AB - Background: Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors. Methods: A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling. Results: A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028). Conclusion: Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.

KW - Disrespect and abuse

KW - Ethiopia

KW - Mistreatment

KW - Respectful maternity care

UR - http://www.scopus.com/inward/record.url?scp=85071631613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071631613&partnerID=8YFLogxK

U2 - 10.1186/s12978-019-0781-y

DO - 10.1186/s12978-019-0781-y

M3 - Article

C2 - 31455400

AN - SCOPUS:85071631613

SN - 1742-4755

VL - 16

JO - Reproductive Health

JF - Reproductive Health

IS - 1

M1 - 130

ER -

Mistreatment of women in public health facilities of Ethiopia

Abstract

Funding

Keywords

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this