Factors associated with Disrespect and Abuse of Women during Delivery in Abia State, Southeast Nigeria
DOI:
https://doi.org/10.60787/tnhj.v24i3.668Keywords:
Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria, Disrespect, abuse, women, associated factors, predictors, Christian Hospital NlaguAbstract
Background: Disrespect and abuse are often multi-factorial and may be perceived differently depending on the setting. This study aimed to identify the factors associated with disrespect and abuse experienced by recently delivered women in Abia State, Nigeria.
Method: This was a cross-sectional study conducted in two purposively selected urban and rural healthcare facilities in Abia State, Nigeria. A total of 312 women of child bearing age recently delivered in the facilities were recruited for the study. A pretested semi-structured validated and adapted interviewer-administered questionnaire was used to collect the data by trained research assistants. Data were entered into Microsoft office Excel 2015 database, and subsequently exported to SPSS statistical software for analyses. Association between disrespect and abuse and some sociodemographic variables was assessed using Chi square test of significance and multivariate analysis. The dependent variables were disrespect and abuse. A p-value of <0.05 was considered statistically significant at 95% confidence interval.
Result: Marital status, educational status, level of income and place of residence were found to be statistically significantly associated with disrespect and abuse. Marital status (OR = 9.15 {1.09-77.11}), educational attainment (OR = 1.80 {1.02-3.15}) and sex of main attending healthcare worker (OR = 1.92 {1.11-3.29}) were identified as predictors of disrespect and abuse in both facilities.
Conclusion: The factors influencing disrespectful and abusive behavior from the study suggest multifaceted factors that require multifaceted approach to mitigating disrespect and abuse.
Downloads
References
Ratcliffe HL, Sando D, Lyatuu GW, Emil F, Mwanyika-Sando M, Chalamilla G, et al. Mitigating disrespect and abuse during childbirth in Tanzania: an exploratory study of the effects of two facility-based interventions in a large public hospital. Reprod Health [Internet]. 2016;13(1):79. (accessed 2017 Dec 5). Available from: http://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-016-0187-z
Kruk M, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedm. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plan. 2014;1–8.
Abuya T, Warren C. E, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. PLoS One [Internet]. 2015;10(4):e0123606. (accessed 2018 Jan 15). Available from: http://dx.plos.org/10.1371/journal.pone.0123606%0Ahttp://www.embase.com/search/results?subaction=viewrecord&from=export&id=L604108043%0Ahttp://dx.doi.org/10.1371/journal.pone.0123606%0Ahttp://bvgcsalud.c17.net/openurl?sid=EMBASE&issn=19326203&id=doi:10.13
Abuya T, Warren C, Ndwiga C, Maranga A, Mbehero F, Njeru A. Reducing disrespect and abuse during facility based childbirth: Promising results from Kenya [Internet]. International Journal of Gynecology and Obstetrics. Elsevier Ireland Ltd; 2015. p. E81. (21st FIGO World Congress of Gynecology and Obstetrics Vancouver, BC Canada. Conference Start: 20151004 Conference End: 20151009; vol. 131). (accessed 2018 Feb 5). Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed13&NEWS=N&AN=72068966
The White Ribbon Alliance for Safe Motherhood. Respectful Maternity Care: The Universal Rights of Childbearing Women. White Ribb Alliance Safe Mother [Internet]. 2011;1–6. (accessed 2018 Jan 22). Available from: http://whiteribbonalliance.org/wp-content/uploads/2013/10/Final_RMC_Charter.pdf
Kujawski S, Mbaruku G, Freedman LP, Ramsey K, Moyo W, Kruk ME. Association Between Disrespect and Abuse During Childbirth and Women???s Confidence in Health Facilities in Tanzania. Matern Child Health J. 2015;19(10):2243–50.
Kruk ME, Paczkowski MM, Tegegn a, Tessema F, Hadley C, Asefa M, et al. Women’s preferences for obstetric care in rural Ethiopia: a population-based discrete choice experiment in a region with low rates of facility delivery. J Epidemiol Community Health. 2010;64(11):984–8.
Bowser D, Hill K. Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth Report of a Landscape Analysis. Harvard Sch Public Heal Univ Res Co, LLC [Internet]. 2010;1–57. (accessed 2018 Jan 5). Available from: http://www.urc-chs.com/uploads/resourceFiles/Live/RespectfulCareatBirth9-20-101Final.pdf
Freedman LP, Kruk ME. Disrespect and abuse of women in childbirth: Challenging the global quality and accountability agendas. Vol. 384, The Lancet. 2014. p. e42–4.
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review. PLoS Med. 2015;12(6).
Jewkes R, Abrahams N, Mvo Z. Why do nurses abuse patients? Reflections from South African obstetric services. Soc Sci Med. 1998;47(11):1781–95.
DeJong J, Akik C, El Kak F, Osman H, El-Jardali F. The safety and quality of childbirth in the context of health systems: mapping maternal health provision in Lebanon. undefined. 2010 Oct;26(5):549–57.
Warren CE, Njue R, Ndwiga C, Abuya T. Manifestations and drivers of mistreatment of women during childbirth in Kenya: Implications for measurement and developing interventions. BMC Pregnancy Childbirth [Internet]. 2017 Mar 28;17(1):1–14. (accessed 2018 Feb 10)Available from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1288-6
Diaz-Tello F. Invisible wounds: Obstetric violence in the United States. Reproductive Health Matters. 2015;
Beck CT. Birth Trauma: In the eye of the beholder. Nurs Res [Internet]. 2004;53(1):28–35. (accessed 2018 Jan 25). Available from: http://ezproxy-prd.bodleian.ox.ac.uk:2081/sp-3.14.0b/ovidweb.cgi?WebLinkFrameset=1&S=AJHFFPABDNDDHCELNCLKOBGCDDCEAA00&returnUrl=ovidweb.cgi%3F%26Full%2BText%3DL%257cS.sh.27.28%257c0%257c00006199-200401000-00005%26S%3DAJHFFPABDNDDHCELNCLKOBGCDDCEAA00&direc
Sando D, Ratcliffe H, McDonald K, Spiegelman D, Lyatuu G, Mwanyika-Sando M, et al. The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy Childbirth [Internet]. 2016;1–10. (accessed 2018 Jan 10). Available from: http://dx.doi.org/10.1186/s12884-016-1019-4
Asefa A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health [Internet]. 2015;12(1):33. (accessed 2018 Jan 12)Available from: http://www.reproductive-health-journal.com/content/12/1/33
Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. In: International Journal of Gynecology and Obstetrics. Elsevier Ireland Ltd; 2014. p. 110–3.
Ishmael Wango Makumi. Disrespect and Abuse of Women during Facility based Deliveries and its Effects on Intent to Use Maternity Services in Uringu Division Meru County. University of Nairobi; 2015.
Ratcliffe HL. Creating an evidence base for the promotion of respectful maternity care. 2013;8–10.
Foluso Ishola, Onikepe Owolabi VF. Disrespect and abuse of women during childbirth in Nigeria: A systematic review. PLoS One. 2017;12(3):1–17.
Charan J, Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med [Internet]. 2013;35(2):121–6. (accessed 2018 Jan 10). Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3775042&tool=pmcentrez&rendertype=abstract
Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. In: International Journal of Gynecology and Obstetrics. 2014. p. 110–3.
Bamgboye EA. lecture notes on research methodology in the health and medical science. first. Ibadan: folbam; 2013. 77–72 p.
Okafor CB, Rizzuto RR. Women’s and health-care providers’ views of maternal practices and services in rural Nigeria. Stud Fam Plann. 2015;25(6 Pt 1):353–61.
Ukke GG, Gurara MK, Boynito WG. Disrespect and abuse of women during childbirth in public health facilities in Arba Minch town, south Ethiopia – a cross-sectional study. PLoS One. 2019 Apr 1;14(4).
Mengesha MB, Desta AG, Maeruf H, Hidru HD. Disrespect and abuse during childbirth in Ethiopia: A systematic review. Vol. 2020, BioMed Research International. Hindawi Limited; 2020.
Adinew YM, Hall H, Marshall A, Kelly J, Mehretie Adinew Y. Disrespect and abuse during facility-based childbirth in central Ethiopia. 2021; (accessed 2022 Jun 22). Available from: https://doi.org/10.1080/16549716.2021.1923327
Sudhinaraset M, Treleaven E, Melo J, Singh K, Diamond-Smith N. Women’s status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory. BMC Pregnancy Childbirth. 2016;16(1).
Diamond-Smith N, Sudhinaraset M, Melo J, Murthy N. The relationship between women’s experiences of mistreatment at facilities during childbirth, types of support received and person providing the support in Lucknow, India. Midwifery. 2016;40:114–23.
Okafor II, Obi SN, Ugwu EO. Impact of Free Maternal and Child Healthcare programme on maternal and neonatal healthcare outcome in Enugu State of Nigeria. Niger J Med J Natl Assoc Resid Dr Niger [Internet]. 2011;20(4):441–3. (accessed 2022 Jan 22)Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22288319 http://sfx.scholarsportal.info/uhn?sid=OVID:medline&id=pmid:22288319&id=doi:&issn=1115-2613&isbn=&volume=20&issue=4&spage=441&pages=441-3&date=2011&title=Nigerian+Journa
United Nations. Sustainable Development Goals - United Nations [Internet]. Sustainable Development. 2016. (accessed 2019 Jun 22). Available from: http://www.un.org/sustainabledevelopment/sustainable-development-goals/%0Ahttp://www.un.org/sustainabledevelopment/sustainable-development-goals/#prettyPhoto
Kassa ZY, Husen S. Disrespectful and abusive behavior during childbirth and maternity care in Ethiopia: A systematic review and meta-analysis. Vol. 12, BMC Research Notes. 2019.
Igboanugo GM, Martin CH. What are pregnant women in a rural Niger Delta community’s perceptions of conventional maternity service provision? An exploratory qualitative study. Afr J Reprod Health [Internet]. 2011;15(3):59–72. (accessed 2022 Jan 22). Available from: http://www.ncbi.nlm.nih.gov/pubmed/22574493
Jewkes R, Penn-Kekana L. Mistreatment of Women in Childbirth: Time for Action on This Important Dimension of Violence against Women. PLoS Med. 2015;12(6).
Uzochukwu BSC, Onwujekwe OE, Akpala CO. Community satisfaction with the quality of maternal and child health services in Southeast nigeria. East Afr Med J. 2004;81(6):293–9.
Raj A, Dey A, Boyce S, Seth A, Bora S, Chandurkar D, et al. Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India. Matern Child Health J. 2017;21(9):1821–33.
Burrowes S, Holcombe SJ, Jara D, Carter D, Smith K. Midwives’ and patients’ perspectives on disrespect and abuse during labor and delivery care in Ethiopia: A qualitative study. BMC Pregnancy Childbirth. 2017;17(1).
Dynes MM, Twentyman E, Kelly L, Maro G, Msuya AA, Dominico S, et al. Patient and provider determinants for receipt of three dimensions of respectful maternity care in Kigoma Region, Tanzania-April-July, 2016 Prof. Suellen Miller. Vol. 15, Reproductive Health. 2018.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Kalu KU, Onyeonoro UU, Amuzie CI, Nwamoh UN
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.
