The prevalence of disrespect and abuse to women giving birth in Mbeya city health facilities from October to December 2016

Abstract

Background Disrespect and Abuse (D&A) in delivering women is a global problem in many low and high income countries though not well documented. Apart from Cost and Distance, recently women’s experience of disrespectful care and abuse related directly to providers actions have been found to affect their place of delivery, and hence many women continue to deliver at home, putting their health at even more risk. The high rates of D&A, along with its contributions to continued home deliveries with no skilled attendance push efforts toward finding possible interventions to decrease or eliminate it. Objectives The study aimed at finding the prevalence of disrespect and abuse to women during childbirth in Mbeya City Health Facilities. Methods A hospital-based cross sectional study was conducted in a period of three months from October 2016 to December 2016 involving 270 women who delivered in six Mbeya City Health Facilities. The women were observed during admission (247), during delivery (183), 23 women were not observed during admission and delivery and 64women were delivered by caesarean section (the study didn’t aim at assessing disrespect and abuse during caesarean delivery). A postnatal observation and an Exit interview was administered to all 270 delivered women. Data analysis was done using IBM SPSS version 20. Frequency and percentages was used to analyse the prevalence and reasons for disrespect and abuse. Categorical variables were compared among women with or without outcome of interest (D&A) and chi square test and p value <0.05 was taken as statistically significant to show association between social demographic and obstetrics characteristics and the experience of disrespect and abuse to the women.

Results Total of 270 women were analysed. The prevalence of D&A during childbirth in Mbeya City health facilities is high 33.3%. Non confidential, non dignified-verbal and neglect were marked in the study. Majority experience it while delivering at the Hospital, p value 0.004. The history of prior physical abuse had association with the report of disrespect and abuse at p value 0.031 and women who delivered by caesarean section reported more disrespect than those who delivered by SVD, at p value 0.001. Women considering D&A as something normal (normalization) and perceiving that providers’ harshness and providers’ poor knowledge of human rights were the most reported reasons for disrespect and abuse Conclusion D&A is alarmingly high in our institutions, though majority of women took the fault to themselves. Including topics on disrespect and abuse during childbirth during ANC visits and maternity blocks is essential to increase women awareness and to develop ways of dealing with D&A.