Disrespect and abuse experienced by women while delivering in health care facilities Pregnancy and Childbirth
Conditions
Interventions
The intervention process involves two main, interacting components:
1. The adaptation of a patient-provider charter
2. A quality improvement (QI) process in the maternity ward in the district hospital
Sponsors
Columbia University Mailman School of Public Health (USA)
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1. Exit interviews: All women 15 years or older discharged after a delivery in the study facilities during a four month period 2. Community follow-up interviews: Women randomly selected from those who complete an exit interview and consent to a follow-up interview in their home 3. Observations: Women who deliver at the 2 study hospitals and the health providers in the maternity wards during the month of observation 4. Qualitative interviews: health providers, community members, health managers, local government officials, regional and national health system stakeholders
Exclusion criteria
Exclusion criteria: N/A
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Reported disrespect and abuse: 1. Single item measures: 1.1. Patient?s private health information shared in a way that others could hear 1.2. Patient?s private health information shared with others without patient?s consent 1.3. Lack of physical privacy 1.4. Shouting/scolding 1.5. Threat of withholding treatment 1.6. Threatening comments 1.7. Negative comments 1.8. Ignored when needed help 1.9. Delivered without attendant 1.10. Non-consent for tubal ligation 1.11. Non-consent for hysterectomy 1.12. Non-consent for cesarean section 1.13. Physical abuse (shouting, slapping, hitting, etc) 1.14. Sexual harassment 1.15. Rape 1.16. Detention in facility for failure to pay 1.17. Request for bribe 2. Categories of items: 2.1. Non-confidential care: 2.1.1. Patient?s private health information shared in a way that others could hear 2.1.2. Patient?s private health information shared with others without patient?s consent 2.1.3. Lack of physical privacy 2.2. Non-dignified care: 2.2.1. Shouting/scolding 2.2.2. Threat of withholding treatment 2.2.3. Threatening comments 2.2.4. Negative comments 2.3. Neglect: 2.3.1. Ignored when needed help 2.3.2. Delivered without attendant 2.4. Non-consented care: 2.4.1. Non-consent for tubal ligation 2.4.2. Non-consent for hysterectomy 2.4.3. Non-consent for cesarean section 2.5. Physical abuse: 2.5.1. Physical abuse (shouting, slapping, hitting, etc) 2.5.2. Sexual harassment 2.5.3. Rape 2.6. Inappropriate demands for payment: 2.6.1. Detention in facility for failure to pay 2.6.2. Request for bribe 3. Overall indicator: Any reported disrespect and abuse: answering ?yes? to any of the single item questions | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Facility utilization 2. Satisfaction with delivery 3. Satisfaction with the health system 4. Perceived quality of care 5. Postpartum depression 6. Health seeking behaviors for mother, infant and other children postpartum 7. Recommendation of facility 8. Use of facility for child health visits 9. Intention to use same facility for next delivery 10. Intention to have more children 11. Self-rated health status | — |
Countries
Tanzania
Outcome results
None listed