RESPECTFUL MATERNITY CARE: A QUALITATIVE STUDY ON THE EXPERIENCE OF HEALTH PROVIDERS IN PUBLIC HEALTH FACILITIES OF NORTH SHEWA ZONE, OROMIA, ETHIOPIA

Abstract

ABSTRACT
BACkGROUND: Emerging evidence indicates that women face humiliating and undignified conditions in health facilities in developing countries like Ethiopia. This negative aspect of maternity care can influence women’s decision not to make use of health facilities. It is, therefore, crucial to examine the experiences of health providers on the provision of respectful maternity care and to identify the forms of disrespect and abuse that exist, and better meet women’s needs as part of broader efforts to provide better quality care. METHODS: A qualitative study employing a phenomenological research design was carried out from August to September 2017 in six woredas/districts of North Shewa Zone, Oromia, Ethiopia. A total of 20 key informant interview was done. The key informants were selected by purposive sampling techniques considering their experience in Maternal, Neonatal and Child Health (MNCH) service delivery in the selected public health facilities. The data were collected using a semi-structured key informant interview guide. All interviews were transcribed and translated verbatim into English. Data analysis was initiated alongside data collection using a thematic approach based on a priori identified themes and those emerged during the analysis.
RESULT: The health providers’ experiences indicated the existence of different categories of disrespect and abuse to women in the study area. Non-consented care, physical abuse, non-confidential care, non-dignified care were the areas identified. Furthermore, painful procedures such as episiotomy were performed without anesthesia, women may also stay for a long time without getting the service and they were restricted to have a companion of their choice in the birthing area. The discrimination of women because of personal attributes such as income level, being rural versus urban, and HIV status was also revealed in the present study. However, detention wasn’t reported by any of the respondents.
CONCLUSION: To promote quality maternal health service, the government in partnership with other stakeholders should address the challenges faced by women in the health facilities. Providers should also be capacitated with the required knowledge, attitude and skill and further effort should be made to equip health facilities with the necessary material and human resource. Enforcing policies on respectful maternity care is also important. kEY WORDS: Respectful Maternity Care, Health Providers Experience, Qualitative Study, Ethiopia (Ethiopian Journal of Reproductive Health; 2019; 11;1:42-51)