Healthcare providers' positive and challenging experiences in implementing the non-medical elements of respectful maternity care at Nyamagana district hospital in Tanzania

Abstract

ABSTRACT Background: The World Health Organization emphasizes integrating and providing respectful maternity care (RMC) as a universal human right to improve maternal and neonatal health outcomes. However, despite this emphasis, exploring RMC through the healthcare workers’ perspective, particularly regarding the non-medical elements, remains inadequately documented, especially in Low—and Middle-Income Countries (LMICs) like Tanzania. The relationship between non-medical RMC and quality of care is crucial in shaping the birth experience and influencing birth outcomes, particularly in the Tanzanian context. Therefore, a deeper exploration of how this is implemented from a provider’s perspective is needed to understand the implications on maternal health outcomes better. Objective: To explore the experiences of health care providers in implementing non-medical elements of respectful maternity care at Nyamagana District Hospital in the Mwanza region. Methods: This qualitative study employed the phenomenological design using in-depth interviews with 12 nurses selected through purposive sampling. The interviews were audio recorded, transcribed, translated, and thematically analyzed using Braun and Clarke’s method. The thematic analysis enabled the identification of key themes regarding dignity, confidentiality, and communication in the provision of RMC. Results: Three main themes emerged: dignity, confidentiality and communication, each with specific barriers and facilitators affecting RMC implementation. Study participants reported several challenges, including high patient load, inadequate facilities and insufficient training, which affected their ability to uphold dignity and maintain confidentiality. Shared spaces hindered privacy, with high workloads and limited communication skills training impeded effective communication with patients. Despite these barriers, the participants highlighted the significance of small acts of kindness and emphasized the positive impact of maintaining respect and empathy during maternity care. Conclusion: The study highlights the need for ongoing training on RMC for healthcare providers. However, training alone is not enough; it must be coupled with efforts to strengthen health systems such as improving infrastructure for patient privacy, ensuring essential resources, cultivating a supportive work environment, and providing cultural competence training to enhance the quality of RMC, ensuring that all women receive dignified, respectful and confidential care during childbirth.