The Proportion and Nature of Disrespect and Abuse during facility-based care in a rural and an urban setting in Kano, northwest Nigeria; A mixed-method study
Abstract:
Objectives: Disrespect and abuse is noted to be
high but poorly reported, especially in northern Nigeria. This study was undertaken
to determine the proportion and nature of disrespect and abuse of women during childbirths
in health facilities at selected locations in Kano, a north-west Nigerian State
Method: Ethical approval and informed consent
were obtained. The study adopted quantitative and qualitative data collection methods.
A sample size of 292 women who delivered in the past 1year preceding the study.
Quantitative data was analyzed using descriptive statistics (frequencies, percentages,
means and standard deviation) and inferential statistics (chi-square). Qualitative
data was analyzed along themes using Atlas.ti. P value is ≤ 0.05 was considered
statistically significant.
Results: The average age of the respondents
was 28.3±6.9 years. Most of the respondents were aged 25-29 years, mostly married
(96%), housewives (68.8%), of Hausa tribe (85.1%) and had primary education (52.2%).
About 50.7% were urban and 49.3% were rural residents. Averagely, 46.5% said that
they experienced D&A during care but it was more in urbn (76.3%), compared to
rural (18.30%). More than one type of D&A occurred in most individual (76%)
mainly at multiple service points, but physical abuse is the most recurrent in various
mix. Among types of D&A occurring singly, non-consented care and non-confidential
care were mostly reported. Downward pressure placed on the abdomen before baby was
born, being blamed for something that happened to them or their babies, health workers
did not provide explanations for procedures and sexual abuse were also reported.
Conclusion: D&A is common in health facilities
in both rural and urban settings of Kano. However, D&A was higher in urban compare
to the rural areas. The proportion among urban women was higher than that reported
in a previous study in Kano. Although D&A types commonly occurred as a mix.
Further studies to explore the determinants and recommendations for D&A are
necessary.
Keywords: Proportion, Nature, Disrespect, Abuse, Health Facility,
Nigeria.
References:
[1].
Ishola
F, Owolabi O, Filippi V (2017) Disrespect and abuse of women during childbirth in
Nigeria: A systematic review. PLoS ONE 12(3): e0174084. https://doi.org/10.1371/journal.pone.0174084.
[2].
Joy
Orpin, Shuby Puthussery Rosemary Davidson and Barbara Burden Women’s experiences
of disrespect and abuse in maternity care facilities in Benue State, Nigeria. BMC
Pregnancy and Childbirth201818:213
[3].
WHO.
Standards for improving quality of maternal and newborn care in health facilities.
Geneva: World Health Organization; 2016. http://apps.who.int/iris/handle/10665/63192
[4].
TuncalpӦ,
Were WM, MacLennan C, Oladapo OT, Gulmezoglu AM, Bahl R, Daelmans B, Mathai M, Say
L, Kristensen F, Temmerman M, Bustreo F. Quality of care for pregnant women and
newbornsthe WHO vision. BJOG 2015; 122: 1045-1049.
[5].
Rance
S, McCourt C, Rayment J, Mackintosh N, Carter W, Watson K, et al. Women's safety
alerts in maternity care: is speaking up enough? BMJ Qual Saf. 2013;22(4):348
[6].
Bowser
MPH. Hill, H. In: Exploring evidence for disrespect and abuse in facility-based
childbirth; 2010.
[7].
Sando,
David &Ratcliffe, Hannah & Banks, Kathleen &Spiegelman, Donna &
Lyatuu, Goodluck & Mwanyika-Sando, Mary & Emil, Faida& Nell Wegner,
Mary &Chalamilla, Guerino & Langer, Ana. (2016). The prevalence of disrespect
and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy and
Childbirth. 16. 10.1186/s12884-016-1019-4.
[8].
Swahnberg
K, Schei B, Hilden M, Halmesmäki E, Sidenius K, Steingrimsdottir T, et al. Patients
experiences of abuse in health care: a Nordic study on prevalence and associated
factors in gynaecological patients. J Psychosom Obstet Gynaecol. 2007;86(3):349–56.
[9].
Bohren
MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of
women during childbirth in health facilities globally: a mixed-methods systematic
review. PLoS Med. 2015;12(6)
[10].
Bohren
MA, Vogel JP, Tuncalp O, Fawole B, Titiloye MA, Olutayo AO, et al. Mistreatment
of women during childbirth in Abuja, Nigeria: a qualitative study on perceptions
and experiences of women and healthcare providers. Reprod Health. 2017;14(9)
[11].
Lukasse
M, Schroll A, Karro H, Schei B, Steingrimsdottir T, Van Parys A, et al. Prevalence
of experienced abuse in healthcare and associated obstetric characteristics in six
European countries. Acta Obstet Gynecol Scand. 2015; 94(5):508–17.
[12].
Sethi
R, Gupta S, Oseni L, Mtimuni A, Rashidi T, Kachale F. The prevalence of disrespect
and abuse during facility-based maternity care in Malawi: evidence from direct observations
of labour and delivery. Reprod Health. 2017; 14:11.
[13].
Abuya
T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence
of disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2015;10(4)
[14].
Sando
D, Ratcliffe H, McDonald K, Spiegelman D, Lyatuu G, Mwanyika- Sando M, et al. The
prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania.
BMC Pregnancy Childbirth. 2016; 16:236.
[15].
Idris
SH, Sambo MN, Ibrahim MS. Barriers to utilisation of maternal health services in
a semi-urban community in northern Nigeria: the client’s perspective. Nigerian Medical
Journal: Journal of the Nigeria Medical Association. 2013;54(1):27–32.
[16].
Moore
BM, Alex-Hart BA, George IO. Utilisation of health care services by pregnant mothers
during delivery: a community-based study in Nigeria. East Afr J Public Health. 2011;8(1):49–51.
[17].
Amole
TG, Tukur MJ, Farouk SL, Ashimi AO. Disrespect and abuse during facility-based childbirth:
The experience of mothers in Kano, Northern Nigeria. Trop J Obstet Gynaecol 2019;
36:21-7.
[18].
Okafor
II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a
low-income country. Int J Gynaecol Obstet. 2015;128(2):110–3
[19].
Abuya
T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence
of disrespect and abuse during childbirth in Kenya. PLoS One. 2015;10(4): e0123606.
[20].
Asefa
A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth
in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health. 2015;12(1):1.
[21].
Kruk
ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive
treatment during facility delivery in Tanzania: a facility and community survey,
Health Policy and Planning, czu079. Available at: https://doi.org/10.1093/heapol/czu079.
Accessed 2 Oct 2017.
[22].
Moher
D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting
items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.
Syst Rev. 2015;4(1):1.
[23].
Sando
D, Abuya T, Asefa A, Banks KP, Freedman LP, Kujawski S, Markovitz A, Ndwiga C, Ramsey
K, Ratcliffe H, Ugwu EO, Warren CE and Jolivet RR. Methods used in prevalence studies
of disrespect and abuse during facility-based childbirth: lessons learned. Reproductive
Health 2017; 14:127 DOI 10.1186/s12978-017-0389-z.
[24].
Ijadunola
MY, Olotu EA, Oyedun OO, Eferakeya SO, Ilesanmi FI, Fagbemi AT, Fasae OC. Lifting
the veil on disrespect and abuse in facility-based child birth care: findings from
South West Nigeria. BMC Pregnancy Childbirth (2019) 19: 39. https://doi.org/10.1186/s12884-019-2188-8.
[25].
Moronkola
OA, Omonu JB, Iyayi DA, Tiamiyu MA. Perceived determinants of the utilization of
maternal health-care services by rural women in Kogi State, Nigeria. Tropical Doctor.
2007;37(2):94–6. pmid:17540090.
[26].
Wassihun
B, Zeleke S. Compassionate and respectful maternity care during facility based child
birth and women's intent to use maternity service in Bahir Dar, Ethiopia. BMC Pregnancy
Childbirth. 2018;18(1):294. Published 2018 Jul 9. doi:10.1186/s12884-018-1909-8.
[27].
Mesenburg
MA, Victora CG, Serruya SJ, de León RP, Damaso AH, Domingues MR, da Silveir MF.
Disrespect and abuse of women duringthe process of childbirth in the 2015Pelotas
birth cohort. Reproductive Health (2018) 15:54 https://doi.org/10.1186/s12978-018-0495-6.
[28].
Uzochukwu
BS, Onwujekwe OE, Akpala CO. Community satisfaction with the quality of maternal
and child health services in southeast Nigeria. East Afr Med J. 2004;81(6):293–9.
Epub 2005/09/20. pmid:16167676.