scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Bonsu Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Professional Practice ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Healthcare Facilities ◽  
Qualitative Research Design ◽  
Marginalized Groups ◽  
Data Saturation ◽  
Service Training ◽  
Childbearing Women

Abstract Background Midwives’ disrespect and abuse of childbearing women have deleterious consequences on maternal and neonatal health. Thus, understanding midwives’ views on the subject is critical to addressing the threat. Views of many stakeholders, except midwives, on disrespect and abusive care (D&AC) are frequently researched. This paper, therefore, explored the views of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana. Method Phenomenological qualitative research design was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen midwives. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyze the data. Findings The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. Socioeconomic inequalities and health system structures and processes emerged as facilitators of D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and the general labour ward childbearing women. Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC.

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Maternity Care ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.Methods An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.Results The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Maternity Care ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.Methods An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.Results The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku(New Corresponding Author) ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi(Former Corresponding Author) ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Study Data ◽  
Public Health Issue ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background: Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. on this common emerging public health issue of disrespect and abusive care (D&AC) have been explored, except for midwives. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana. Method: An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen midwives. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data. Findings: The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim blaming, and health system related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward. Conclusion: The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC.

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.

2019 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Maternity Care ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Childbearing Women

Abstract Background: Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana. Method: An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data. Findings: The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward. Conclusion: The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC. Keywords Disrespectful maternity care, childbearing women, midwives, Ghana, qualitative

scholarly journals “I wouldn’t have hit you, but you would have killed your baby:” exploring midwives’ perspectives on disrespect and abusive Care in Ghana

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Millicent Dzomeku ◽  
Adwoa Bemah Boamah Mensah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternal Health ◽  
Professional Practice ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Healthcare Facilities ◽  
Interpretative Approach ◽  
Childbearing Women

Abstract Background Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana. Methods An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen interviews. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data. Results The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim-blaming, and health system-related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward. Conclusion The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC.

scholarly journals Exploring midwives’ understanding of respectful and non-abusive maternal care in Kumasi, Ghana: Qualitative Inquiry

2019 ◽  
Author(s):  
Dzomeku Veronica Millicent ◽  
Bonsu Adwoa Bemah ◽  
Nakua Kweku Emmanuel ◽  
Agbadi Pascal ◽  
Lori R. Jody ◽  
...  
Keyword(s):  
Maternity Care ◽  
Maternal Care ◽  
Study Data ◽  
Qualitative Inquiry ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Evidenced Based

AbstractBackgroundVarious aspects of disrespect and abusive maternity care have received scholarly attention because of frequent reports of the phenomenon in most healthcare facilities globally, especially in low- and middle-income countries. However, the perspectives of skilled providers on respectful maternal care have not been extensively studied. Midwives’ knowledge of respectful maternity care is critical in designing any interventive measures to address the menace of disrespect and abuse in maternity care. Therefore, the present study sought to explore the views of midwives on respectful maternity care at a Teaching Hospital in Kumasi, Ghana.MethodsPhenomenological qualitative research design was employed in the study. Data were generated through individual in-depth interviews, which were audio-recorded and transcribed verbatim. Data saturation was reached with fifteen midwives. Open Code 4.03 was used to manage and analyse the data.FindingsThe midwives’ understanding of respectful maternity care was comprised of the following components: non-abusive care, consented care, confidential care, non-violation of childbearing women’s basic human rights, and non-discriminatory care. Probing questions to solicit midwives’ opinions on an evidenced-based component of respectful maternity care generated little information, suggesting that the midwives have a gap in knowledge regarding this component of respectful maternity care.ConclusionMidwives reported an understanding of most components of respectful maternity care, but their gap in knowledge on evidenced-based care requires policy attention and in-service training. To understand the extent to which this gap in knowledge can be generalized for midwives across Ghana to warrant a redesign of the national midwifery curriculum, the authors recommend a nationwide cross-sectional quantitative study.

Midwives' perceptions of disrespect and abuse of women during labour and childbirth in Lusaka, Zambia

2021 ◽  
Vol 15 (3) ◽  
pp. 1-12
Author(s):  
Namayipo Stella Wamukankamba Nankamba ◽  
Catherine Mubita Ngoma ◽  
Maureen Masumo Makoleka
Keyword(s):  
Logistic Regression ◽  
Maternity Care ◽  
Health Workers ◽  
Multivariate Logistic Regression Analysis ◽  
Study Data ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Multivariate Logistic Regression ◽  
Abuse Of Women ◽  
And Training

Background/Aims Disrespect and abuse is a frequent occurrence in labour wards around the world. Disrespect and abuse during care by health workers can prevent pregnant women from seeking care during labour and childbirth, which can lead to increased maternal and neonatal mortality rates. This study aimed to explore midwives' perceptions of disrespect and abuse of women during labour and childbirth in Lusaka. Methods A concurrent convergent mixed-method approach was used for this study. Data were collected through a self-administered questionnaire given to 217 midwives actively practicing in maternal health services across Lusaka randomly sampled for the quantitative arm of the study. The data were analysed using bivariate and multivariate logistic regression, with P<0.05 used to indicate significance. For the qualitative component of the study, 13 purposively selected key informants were interviewed with an interview guide. Results Most of the respondents (88.5%) perceived disrespect and abuse of women during labour and childbirth as a negative phenomenon. However, almost half (40.1%) had provided care which was disrespectful and abusive during their practice and the majority (68.7%) had observed disrespect and abuse by other midwives. Bivariate and multivariate logistic regression analysis found an association between midwives' perception of disrespect and abuse and witnessing or participating in disrespectful and abusive behaviour during practice. In the qualitative arm of the study, midwives reported that disrespect and abuse occurred in labour wards across Lusaka, demonstrating an urgent need to prevent such practices. Midwives suggested actions such as increased sensitisation and training of midwives on respectful maternity care and improved staffing levels as ways to prevent this practice Conclusions Disrespect and abuse of women during labour and childbirth should be prevented. Increasing health education and training for both the public and midwives on respectful maternity care can help to achieve this goal. Midwives need to be motivated through good working environments, increased wages and increased time to rest while working, as the heavy workload was found to contribute to disrespect and abuse in labour wards.

scholarly journals Exploring the Feasibility of using a four-day Training Program to Change the Culture of Disrespect and Abuse in Maternity Care in Ghana

2020 ◽  
Author(s):  
Millicent Veronica Dzomeku ◽  
Adwoa Bemah Boamah Mensah ◽  
Emmanuel Kweku Nakua ◽  
Alberta Lomotey ◽  
Pascal Agbadi ◽  
...  
Keyword(s):  
Training Program ◽  
Maternity Care ◽  
Cost Effective ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Interactive Mode ◽  
Middle Income Countries ◽  
Focused Antenatal Care

Abstract Objectives To improve childbirth experiences for childbearing women in healthcare facilities in low-and-middle-income countries, it is important to implement a cost-effective intervention to change the culture of disrespect and abuse in maternity care. Thus, we explored the feasibility of using four Respectful Maternity Care Modules in a training program to change the culture of disrespect and abuse in maternity care in a teaching hospital in Kumasi, Ghana.Results Midwives were trained on respect and dignity in childbirth, effective communication, focused antenatal care, and the use of alternative birthing positions for delivery. The statistical test revealed a statistically significant increase in knowledge of RMC following participation in the RMC-M training, z = − 3.43, p = 0.001, with a large effect size (r = 0.63). The median score on the self-developed Respectful Maternity Care Questionnaire increased from pre-program (Md = 10) to post-program (Md = 15). The experts remarked that the content of the training was adequate to enhance midwives’ knowledge, skills, and attitude to provide respectful maternal care. They recommended the inclusion of teaching methods that engages the adult learner in an interactive mode.

scholarly journals Midwives’ experiences of implementing respectful maternity care knowledge in daily maternity care practices after participating in a four-day RMC training

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Millicent Dzomeku ◽  
Adwoa Bemah Boamah Mensah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternity Care ◽  
Positive Impact ◽  
Good Practice ◽  
Healthcare Facility ◽  
Positive Influence ◽  
Respectful Maternity Care ◽  
Training Workshop ◽  
Care Practices ◽  
The Impact ◽  
Childbearing Women

Abstract Background In Ghana, studies documenting the effectiveness of evidence-based specialized training programs to promote respectful maternity care (RMC) practices in healthcare facilities are few. Thus, we designed a four-day RMC training workshop and piloted it with selected midwives of a tertiary healthcare facility in Kumasi, Ghana. The present paper evaluated the impact of the training by exploring midwives’ experiences of implementing RMC knowledge in their daily maternity care practices 4 months after the training workshop. Methods Through a descriptive qualitative research design, we followed-up and conducted 14 in-depth interviews with participants of the RMC training, exploring their experiences of applying the acquired RMC knowledge in their daily maternity care practices. Data were managed and analysed using NVivo 12. Codes were collapsed into subthemes and assigned to three major predetermined themes. Results The findings have been broadly categorized into three themes: experiences of practising RMC in daily maternity care, health facility barriers to practising RMC, and recommendations for improving RMC practices. The midwives mentioned that applying the newly acquired RMC knowledge has positively improved their relationship with childbearing women, assisted them to effectively communicate with the women, and position them to recognize the autonomy of childbearing women. Despite the positive influence of the training on clinical practice, the midwives said the policy and the built environment in the hospital does not support the exploration of alternative birthing positions. Also, the hospital lacked the required logistics to ensure privacy for multiple childbearing women in the open labour ward. The midwives recommended that logistics for alternative birthing positions and privacy in the ward should be provided. Also, all midwives and staff of the hospital should be taken through the RMC training program to encourage good practice. Conclusion Despite the report of some RMC implementation challenges, the midwives noted that the 4-day RMC training has had a positive impact on their maternity caregiving practice in the hospital. Policies and programs aimed at addressing the issue of disrespect and abusive practices during maternity care should advocate and include the building of facilities that support alternative birthing positions and privacy of childbearing women during childbirth.

scholarly journals Efficiency of Health Care Risk Waste Management in Rural Healthcare Facilities of South Africa: An Assessment of Selected Facilities in Vhembe District, Limpopo Province

2019 ◽  
Vol 16 (12) ◽  
pp. 2199 ◽  
Author(s):  
Foluke C. Olaniyi ◽  
Jason S. Ogola ◽  
Takalani G. Tshitangano
Keyword(s):  
South Africa ◽  
Healthcare Facility ◽  
Study Data ◽  
Limpopo Province ◽  
Healthcare Facilities ◽  
The Public ◽  
Efficient Management ◽  
The Social ◽  
Vhembe District ◽  
And Storage

Waste generated form healthcare facilities is a potential source of health risks to the public, if it is not properly handled from the point of generation to disposal. This study was conducted to assess the efficiency of healthcare risk waste (HCRW) management in Vhembe District of Limpopo Province, South Africa. Fifteen healthcare facilities were selected in Vhembe District for this study. Data were obtained through in-depth interviews, semi-structured questionnaires, observation and pictures. Qualitative data were thematically analyzed, while the quantitative data were analyzed using the Statistical Package for the Social Sciences, version 25. In all the healthcare facilities; mismanagement of HCRW was noted at different points along the management chain. Poor segregation, overfilling of waste bins, inappropriate transportation and storage of waste in substandard storage rooms were observed in the facilities. All the waste from the district are transported to a private-owned treatment facility outside the district, where they are mainly incinerated. Enforcement of healthcare risk waste guidelines, provision of standardized equipment for temporary storage, empowerment of each healthcare facility to treat at least some of the waste, and employment of non-burn techniques for treatment of waste are recommended for more efficient management of healthcare risk waste in Vhembe District.

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