Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia
Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia
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DOI：
10.1186/s12978-015-0024-9
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发表时间：
2015-04-16
影响因子：
3.4
通讯作者：
Bekele, Delayehu
中科院分区：
文献类型：
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作者：
Asefa, Anteneh;Bekele, Delayehu
背景资料：根据2011年埃塞俄比亚人口和健康调查，90.1%的母亲不在卫生设施分娩，29.5%的母亲认为非传统服务是原因。在低收入和中等收入国家，熟练助产护理水平低是孕产妇死亡的主要原因之一。在四个卫生机构进行了一项横断面研究（一所专门教学医院及其三个集水区保健中心），以定量确定妇女在设施分娩期间面临的不尊重和虐待的程度和类型，沿着他们的不尊重和虐待的主观经历。一份问卷调查管理173名母亲出院前立即从各自的卫生设施。报告的不尊重和虐待分娩过程中进行了测量，在七个类别，使用23个性能indicators.Results：在多胎母亲（n = 103），71.8%的历史，以前的机构出生和78%（75.3%在卫生中心和81.8%在医院，P = 0.295）的受访者经历了一个或多个类别的不尊重和虐待。所有在医院分娩的妇女和89.4%在保健中心分娩的受访者都报告说，分娩期间的知情权、知情同意权和选择/偏好体位的权利受到侵犯。在39.3%的病例中，母亲在分娩过程中得不到照顾（14.1%在保健中心，63.6%在医院; p < 0.001）。虽然78.6%（n = 136）的受访者客观上面临的不尊重和虐待，只有22（16.2%）主观上经历了不尊重和abuse.Conclusions：这项定量研究揭示了高水平的不尊重和虐待分娩过程中，并没有被认为是这样的大多数受访者。每个妇女都有权在以妇女为中心的环境中分娩，免受不尊重和虐待。如果埃塞俄比亚要成功地增加在设施中分娩的人数，了解妇女如何定义虐待至关重要。
Background: According to the 2011 Ethiopian Demographic and Health Survey, 90.1% of mothers do not deliver in health facilities, with 29.5% citing non-customary service as causative. A low level of skilled attendance at birth is among the leading causes of maternal mortality in low - and middle-income countries.Methods: A cross-sectional study was undertaken in four health facilities (one specialized teaching hospital and its three catchment health centers) in Addis Ababa, Ethiopia, to quantitatively determine the level and types of disrespect and abuse faced by women during facility-based childbirth, along with their subjective experiences of disrespect and abuse. A questionnaire was administered to 173 mothers immediately prior to discharge from their respective health facility. Reported disrespect and abuse during childbirth was measured under seven categories using 23 performance indicators.Results: Among multigravida mothers (n = 103), 71.8% had a history of a previous institutional birth and 78% (75.3% in health centers and 81.8% in hospital; p = 0.295) of respondents experienced one or more categories of disrespect and abuse. The violation of the right to information, informed consent, and choice/preference of position during childbirth was reported by all women who gave birth in the hospital and 89.4% of respondents in health centers. Mothers were left without attention during labor in 39.3% of cases (14.1% in health centers and 63.6% in hospital; p < 0.001). Although 78.6% (n = 136) of respondents objectively faced disrespect and abuse, only 22 (16.2%) subjectively experienced disrespect and abuse.Conclusions: This quantitative study reveals a high level of disrespect and abuse during childbirth that was not perceived as such by the majority of respondents. It is every woman's right to give birth in woman-centered environment free from disrespect and abuse. Understanding how women define abuse is crucial if Ethiopia is to succeed in increasing the uptake of facility-based births.