Abstract:
Background: Disrespect and abuse of women during facility based childbirth has been
documented throughout the world and it is one of the most common deterrents to maternal
health care utilization. This may result in high maternal morbidities and mortalities. Despite,
its negative impact, this practice remains hidden and unspoken.
Objective: The aim of this study was to assess predictors of disrespect and abuse during
childbirth experienced by women’s in public hospitals, Silte Zone, South Ethiopia, March 1to
March 30,2018.
Methods: A facility based cross sectional study design supplemented by qualitative data
collection method. Structured questionnaire was used to collect the quantitative data and
semi-structured interview guide was used to collect data for qualitative study. Women's
subjective experiences of disrespect and abuse during childbirth were obtained through exit
interviews. Systematic sampling technique was used to select the 422 study participants.
Disrespect & Abuse was measured according to the seven categories proposed by Bowser
and Hill by using 24 performance indicators. Data was entered by using Epi-data version
3.1and exported to SPSS version 23.0 for analysis. Bivariate and multivariate logistic
regression with 95 % confidence interval was carried out. For qualitative study, the data was
analyzed manually.
Result: From the total of 422 women interviewed 409 responded for the question with a
response rate of 96.9%.The overall prevalence of disrespect and abuse was 67.7% with 95%
confidence interval. The most prevalent form of disrespect and abuse were non-consented
care 236(65.8%) and physical abuse 230(56.2%).Having antenatal care follow up
(AOR=0.51, 95% CI ((0.31, 0.79), presence of complication during childbirth (AOR=2.55,
95%CI (1.07, 6.06), presence of birth companion (AOR=0.35, 95%CI (0.21, 0.57), stay at
health facility (AOR=2.63, 95%CI (1.34, 5.18) were predictors of disrespect and abuse.
Conclusions and recommendation: Prevalence of disrespect and abuse during childbirth
was high in the study area. Having antenatal care follow up, presence of complication during
childbirth, presence of birth companion and stay at health facility after delivery were
predictors of disrespect and abuse. Ethiopia aspires to provide respectful maternal care at
health facilities. But this high prevalence of disrespect and abuse calls for sustained and
coordinated efforts to improve quality of maternal care.
