Exploring the prevalence of disrespect and abuse during childbirth in Kenya.
Exploring the prevalence of disrespect and abuse during childbirth in Kenya.
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DOI：
10.1371/journal.pone.0123606
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Bellows B
中科院分区：
文献类型：
--
作者：
Abuya T;Warren CE;Miller N;Njuki R;Ndwiga C;Maranga A;Mbehero F;Njeru A;Bellows B
护理质量差，包括卫生工作者对不尊重和虐待 (D&A) 的恐惧，影响了妇女寻求产科护理的决定。 D&A 的主要表现包括：身体虐待、未经同意的护理、非保密护理、非尊严护理、歧视、遗弃和设施拘留。本文描述了肯尼亚经历的 D&A 的表现形式并衡量了其流行程度。本文基于一项前后研究中收集的基线数据，该研究旨在衡量一揽子干预措施的效果，以减少肯尼亚 13 个卫生机构中妇女在分娩和分娩期间经历的 D&A 患病率。数据是通过对 641 名产妇出院后的出院调查收集的。我们使用多元固定效应逻辑回归模型呈现 D&A 表现的百分比及其与人口特征的关系的优势比。 20% 的女性报告过任何形式的 D&A。 D&A 的表现形式包括：非保密护理（8.5%）、非尊严护理（18%）、忽视或遗弃（14.3%）、非自愿护理（4.3%）、身体虐待（4.2%）以及因不付费用而拘留（8.1）。与 19 岁以下的女性相比，20-29 岁的女性接受非保密护理的可能性较小；或：[0.6 95% CI（0.36，0.90）； p=0.017]。送货过程中没有陪同的客户不太可能遇到不适当的付款要求；或：[0.49（0.26，0.95）； p=0.037]；与生育第一胎的妇女相比，生育次数较高的妇女因欠薪而被拘留的可能性高出三倍，受贿的可能性高出五倍。五分之一的女性在分娩过程中经历过羞辱。报告了肯尼亚分娩期间六类 D&A。了解 D&A 的流行情况对于在国家、卫生机构和社区层面制定干预措施至关重要，以解决影响设施中 D&A 的因素和驱动因素，并鼓励客户未来使用设施。
Poor quality of care including fear of disrespect and abuse (D&A) perpetuated by health workers influences women’s decisions to seek maternity care. Key manifestations of D&A include: physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination, abandonment, and detention in facilities. This paper describes manifestations of D&A experienced in Kenya and measures their prevalence. This paper is based on baseline data collected during a before-and-after study designed to measure the effect of a package of interventions to reduce the prevalence of D&A experienced by women during labor and delivery in thirteen Kenyan health facilities. Data were collected through an exit survey of 641 women discharged from postnatal wards. We present percentages of D&A manifestations and odds ratios of its relationship with demographic characteristics using a multivariate fixed effects logistic regression model. Twenty percent of women reported any form of D&A. Manifestations of D&A includes: non-confidential care (8.5%), non-dignified care (18%), neglect or abandonment (14.3%), Non-consensual care (4.3%) physical abuse (4.2%) and, detainment for non-payment of fees (8.1). Women aged 20-29 years were less likely to experience non-confidential care compared to those under 19; OR: [0.6 95% CI (0.36, 0.90); p=0.017]. Clients with no companion during delivery were less likely to experience inappropriate demands for payment; OR: [0.49 (0.26, 0.95); p=0.037]; while women with higher parities were three times more likely to be detained for lack of payment and five times more likely to be bribed compared to those experiencing there first birth. One out of five women experienced feeling humiliated during labor and delivery. Six categories of D&A during childbirth in Kenya were reported. Understanding the prevalence of D&A is critical in developing interventions at national, health facility and community levels to address the factors and drivers that influence D&A in facilities and to encourage clients’ future facility utilization.
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影响因子：
168.9
作者：
Garcia-Moreno, Claudia;Jansen, Henrica A. F. M.;Watts, Charlotte H.
通讯作者：
Watts, Charlotte H.
影响因子：
--
作者：
Kyomuhendo, GB
通讯作者：
Kyomuhendo, GB
影响因子：
3.1
作者：
McMahon, Shannon A.;George, Asha S.;Winch, Peter J.
通讯作者：
Winch, Peter J.
影响因子：
3.1
作者：
Warren C;Njuki R;Abuya T;Ndwiga C;Maingi G;Serwanga J;Mbehero F;Muteti L;Njeru A;Karanja J;Olenja J;Gitonga L;Rakuom C;Bellows B
通讯作者：
Bellows B
影响因子：
5.4
作者：
Jewkes, R;Levin, J;Penn-Kekana, L
通讯作者：
Penn-Kekana, L