Prevalence of disrespect or abuse in maternity care and its associated factors during child birth in Sheka zone, Southwest Ethiopia: A facility-based cross-sectional study

Abstract

Background: Disrespect or abuse is a mistreatment of women during pregnancy, childbirth or postpartum period. It is one of the contributing factors of low up take of institutional delivery. In Ethiopia, there is little information about disrespect or abuse during childbirth in public health facilities. Objective: To determine the prevalence of disrespect or abuse and to assess its associated factors in maternity care during childbirth among women who gave birth in public health facilities of Sheka Zone, Southwest Ethiopia, 2018. Methods: A facility based cross-sectional study with quantitative and qualitative data was conducted from March to April, 2018 at six randomly selected health centers and one general hospital. Pretested and structured questionnaires were used. The samples were allocated to selected health facilities based on their delivery case load six months prior to the study period. Informed consent was obtained and consecutive sampling technique was employed until the desired sample is obtained. Data were entered into Epi Data version 3.1 and exported to SPSS version 23 for analysis. Frequency distribution tables were used to summarize the data. Chia-quare test and binary logistic regression were done to select variables associated with disrespect or abuse. Multiple logistic regression analysis was used to identify predictors of disrespect or abuse and statistical significance was declared at p-value <0.05. Results: A total of 355 participants were enrolled to this study with mean age of 25.62 ± 5.77 years. The finding of the study showed that 303 (85.4%) women experienced at least one form of disrespect or abuse. The odds of women with parity of two and above to face disrespect or abuse was 2.56 times (AOR=2.564, 95% CI: 1.576 - 8.498) more than women with parity of one. Women with complication during labor and delivery were 2.44 times (AOR= 2.442; 95% CI: 1.358 - 6.194) more disrespected and abused than women without complication. The odds of disrespect or abuse of women who were attended by female health care providers was 3 times more (AOR=3.19; 95% CI: 1.316-7.735) than those women attended by males. Health care providers, facility related, provider related and women related factors were also identified as contributors to disrespectful or abusive care during facility based childbirth. Conclusion: This study revealed high prevalence of disrespect or abuse during facility based childbirth in the studied health facilities. Parity, any complication during labor & delivery, and the sex of the provider were the predictors of disrespect or abuse. The health facilities were recommended to give special attention to multiparous and women with complications and also to monitor closely the maternity care services to reduce the prevalence of disrespect or abuse.