TY - JOUR
T1 - Mistreatment of women during childbirth in Abuja, Nigeria
T2 - A qualitative study on perceptions and experiences of women and healthcare providers Prof. Suellen Miller
AU - Bohren, Meghan A.
AU - Vogel, Joshua P.
AU - Tunçalp, Özge
AU - Fawole, Bukola
AU - Titiloye, Musibau A.
AU - Olutayo, Akinpelu Olanrewaju
AU - Ogunlade, Modupe
AU - Oyeniran, Agnes A.
AU - Osunsan, Olubunmi R.
AU - Metiboba, Loveth
AU - Idris, Hadiza A.
AU - Alu, Francis E.
AU - Oladapo, Olufemi T.
AU - Gülmezoglu, A. Metin
AU - Hindin, Michelle J.
N1 - Funding Information:
The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding for this project was received from The United States Agency for International Development (USAID) and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization. Meghan Bohren was also supported by the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health, the Bernard and Jane Guyer Scholarship in Maternal and Child Health, and the Caroline Cochran Scholarship in Population and Reproductive Health.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/1/17
Y1 - 2017/1/17
N2 - Background: Global efforts have increased facility-based childbirth, but substantial barriers remain in some settings. In Nigeria, women report that poor provider attitudes influence their use of maternal health services. Evidence also suggests that women in Nigeria may experience mistreatment during childbirth; however, there is limited understanding of how and why mistreatment this occurs. This study uses qualitative methods to explore women and providers' experiences and perceptions of mistreatment during childbirth in two health facilities and catchment areas in Abuja, Nigeria. Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were used with a purposive sample of women of reproductive age, midwives, doctors and facility administrators. Instruments were semi-structured discussion guides. Participants were asked about their experiences and perceptions of, and perceived factors influencing mistreatment during childbirth. Thematic analysis was used to synthesize findings into meaningful sub-themes, narrative text and illustrative quotations, which were interpreted within the context of this study and an existing typology of mistreatment during childbirth. Results: Women and providers reported experiencing or witnessing physical abuse including slapping, physical restraint to a delivery bed, and detainment in the hospital and verbal abuse, such as shouting and threatening women with physical abuse. Women sometimes overcame tremendous barriers to reach a hospital, only to give birth on the floor, unattended by a provider. Participants identified three main factors contributing to mistreatment: poor provider attitudes, women's behavior, and health systems constraints. Conclusions: Moving forward, findings from this study must be communicated to key stakeholders at the study facilities. Measurement tools to assess how often mistreatment occurs and in what manner must be developed for monitoring and evaluation. Any intervention to prevent mistreatment will need to be multifaceted, and implementers should consider lessons learned from related interventions, such as increasing audit and feedback including from women, promoting labor companionship and encouraging stress-coping training for providers.
AB - Background: Global efforts have increased facility-based childbirth, but substantial barriers remain in some settings. In Nigeria, women report that poor provider attitudes influence their use of maternal health services. Evidence also suggests that women in Nigeria may experience mistreatment during childbirth; however, there is limited understanding of how and why mistreatment this occurs. This study uses qualitative methods to explore women and providers' experiences and perceptions of mistreatment during childbirth in two health facilities and catchment areas in Abuja, Nigeria. Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were used with a purposive sample of women of reproductive age, midwives, doctors and facility administrators. Instruments were semi-structured discussion guides. Participants were asked about their experiences and perceptions of, and perceived factors influencing mistreatment during childbirth. Thematic analysis was used to synthesize findings into meaningful sub-themes, narrative text and illustrative quotations, which were interpreted within the context of this study and an existing typology of mistreatment during childbirth. Results: Women and providers reported experiencing or witnessing physical abuse including slapping, physical restraint to a delivery bed, and detainment in the hospital and verbal abuse, such as shouting and threatening women with physical abuse. Women sometimes overcame tremendous barriers to reach a hospital, only to give birth on the floor, unattended by a provider. Participants identified three main factors contributing to mistreatment: poor provider attitudes, women's behavior, and health systems constraints. Conclusions: Moving forward, findings from this study must be communicated to key stakeholders at the study facilities. Measurement tools to assess how often mistreatment occurs and in what manner must be developed for monitoring and evaluation. Any intervention to prevent mistreatment will need to be multifaceted, and implementers should consider lessons learned from related interventions, such as increasing audit and feedback including from women, promoting labor companionship and encouraging stress-coping training for providers.
KW - Abuse
KW - Childbirth
KW - Disrespect
KW - Maternal health
KW - Mistreatment
KW - Nigeria
KW - Obstetric delivery
KW - Qualitative research
KW - Quality of care
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U2 - 10.1186/s12978-016-0265-2
DO - 10.1186/s12978-016-0265-2
M3 - Article
C2 - 28095911
AN - SCOPUS:85011850459
SN - 1742-4755
VL - 14
JO - Reproductive health
JF - Reproductive health
IS - 1
M1 - 9
ER -