Assessment of Womens Experience of Care during Childbirth for Quality Improvement at Level 5 Health Facilities in Bungoma County Kenya.
High maternal and newborn mortality is a pressing problem in developingrncountries. Poor treatment during childbirth contributes directly andrnindirectly to this problem. Many women experience disrespectful andrnabusive treatment during childbirth worldwide which violates their rights.rnIn Kenya 20 of women report having experienced some form ofrndisrespect and abuse DA. Bungoma County is among the 15 countiesrnwith the worst maternal and newborn health statistics in Kenya. Thernmaternal mortality rate is 382 per 100000 live births and newborn deathsrn32 per 1000 live births while skilled birth attendance is 41.4.
This studyrnwas motivated by the poor maternal and newborn indicators risingrnincidences of DA limited formal research on respectful maternity care.rnThe study aimed at assessing womens experience of care during childbirthrnat Level 5 health facilities in Bungoma County. The specific objectivesrnwere to determine the womens experiences of care during childbirth torndetermine factors contributing to disrespect and abuse during childbirth andrnto identify strategies for addressing issues affecting respectful maternityrncare for promoting quality of maternal and newborn care.
A cross-sectionalrndescriptive study design was used. It involved 360 mothers. Analysis ofrnquantitative data was done using SPSS. Descriptive statistics werernpresented in graphs tables frequencies and percentages. Qualitative datarnwas analysed thematically.
The prevalence of DA was 42.2 youngerrnage and lower education aggravated DA. Autonomy privacy andrnconfidentiality and absence of birth companionship were major aspects ofrnDA. Health workforce shortage inadequate supervision space and beds poor provider-patient relationships were factors leading to DA
On the assessment of the socio-demographicrncharacteristics it was found that younger womenrnwere more likely to experience disrespect and abuserncompared to older women. Married women werernmore likely to experience disrespect and abuse.rnWomen who had primary or less level of educationrnwere more likely to experience disrespect and abusernOverall the study found out that the majority of thernwomen experienced dignity and respect from therndoctors nurses and other healthcare providers. Thernmajority of the healthcare providers werernresponsive to the womens needs offered supportivernand dignified care as well as effectiverncommunication. Despite the positive userrnexperience by most of the respondents somernwomen reported having had a poor experience thatrnwas unfriendly and insensitive. Women whornexperienced poor treatment reported not to deliverrnin the facility in future or recommend anotherrnwoman to deliver in the facility. Inadequate privacyrnand confidentiality autonomy in decision makingrnand not allowing the presence of a birth companionrnduring labour and delivery were found to be majorrnaspects of disrespect and abuse. The prevalence ofrndisrespect and abuse was 42.2.rnIt was found out that the major factor leading torndisrespect and abuse or negative user experiencernwas staff shortage as well as healthcare providersrndemotivation due to lack of promotions andrninadequate support supervision from managers.rnPoor understanding and negative attitudes betweenrnhealthcare providers and women led to disrespectrnand abuse. Communication barrier or not givingrnadequate information to the clients causernincorporation which eventually led to disrespect andrnabuse. Women labouring at home for more than 12rnhours then coming to the hospital with obstetricrnemergencies aggravated disrespect and abuse. Lackrnof adequate medical equipment and supplies healthrnstaff small rooms and lean bed capacity tornaccommodate the patient population and notrnallowing the presence of family members contributed to disrespect and abuse. Not honouringrnwomens cultural practices also led to disrespectrnand abuse.rnStrategies identified in addressing issues affectingrnrespectful maternity care in promoting quality ofrnmaternal and newborn care included the provisionrnof adequate education to mothers during ANC visitsrnso as to ally myths and misconceptions and alsornseek medical care in good time so as to avoidrnobstetric complications. Another strategy was forrnthe health managers to scale up supervision forrnpurposes of accountability and quality checks andrnthat they should not be harsh and problemrnsearching. Healthcare providers should bernwelcoming adhere to privacy and confidentialityrnand listen to clients needs and concerns. Adheringrnto code of regulations by staff/healthcare providers.rnAnother strategy was staff motivation throughrnpromotion and provision of adequate resources.rnRespect of positive cultural practices andrnincorporating respectful maternity care practices inrnthe routine quality checks.rnProvision of respectful maternity care duringrnchildbirth is a womens right and any form ofrndisrespectful and abusive treatment not onlyrnviolates the rights of women to respectful care butrnalso threatens their rights to life health bodilyrnintegrity and freedom from discrimination.
Publication Information
Focus County(s):
Bungoma County
Programme Area(s):
Sexual, Reproductive, Adolescent & Child Health
Research Priority Area(s):
Disease Domain(s):
maternal and neonatal health
Document History:
Publication Date: 05.Jan.2022
Conference Title: