Respectful Maternity Care: A Qualitative Study on the Experience of Health Providers in Public Health Facilities of North Shoa Zone, Oromia Ethiopia

Abrham Getachew ¹, Nebiyou Wondwessen ¹, Tsegaye Bedane ¹,  Delessa Wolde ¹, Tesfalem Teshome Tessema², Fanna Adugna Debele², Andamlak Gizaw Alamdo²

Ethio-Canada MNCH office in Ethiopia¹

St. Paul’s Hospital Millennium Medical College, Department of Public Health, Addis Ababa Ethiopia²

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 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. Furthermore why disrespects are committed by health care providers will be addressed as there are clear reports from clients that show the existence of disrespects.

Methods: A qualitative study employing a phenomenological research design was carried out from August to September 2017 in six woredas /districts of North Shoa zone, Oromia Ethiopia. A total of 20 key informant interviews with health providers working in Maternal, Neonatal and Child health (MNCH) service delivery points of selected public health facilities were conducted. The data were collected by 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 primarily identified themes and those emerged during the analysis

Results: 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 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 vs. urban, and HIV status were also revealed in the present study. However detention wasn’t reported by any of the respondents.

Conclusions:

To promote quality maternal health service, the government in partnership with other stakeholders, should address 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.