Predictors of disrespect and abuse experienced by women during childbirth in public hospital, silte zone, south Ethiopia

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.