Changing the Culture of Disrespect and Abuse in Maternity Care in Kumasi, Ghana

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Abstract The long term career goal of this project is for the applicant to become an independent researcher and gain skills to independently design and implement projects and programs relevant to improving health outcomes (principally for mothers and newborns) in Ghana and sub-Saharan Africa in general. The career development goals fulfill the following objectives: 1) increase knowledge in designing and conducting evaluation research in low-resource settings; 2) increase skills in advanced qualitative methods; 3) build research capacity/advanced quantitative methodologies; 4) build networks with scientists in maternal and child health across the globe; 5) translate research findings into practice guidelines and policy; 6) gain knowledge in the responsible conduct of research; and 7) develop the candidate’s academic career and secure a senior faculty position. The career plan focuses on course work at the University of Ghana Legon, the University of Michigan, and the University of North Carolina. Additionally, there is time built in for participation and presentations at scientific meetings, seminars, and conferences. The Ghanaian mentor, Dr. Peter Donkor is the first ever Director of the Kwame Nkrumah University of Science and Technology responsible for the expansion of research support infrastructure. The US mentor, Dr. Jody Lori has expertise in the field of maternal and child health and in working with midwives in Ghana. She will be involved in all aspects of carrying out the research and training plan. The research project will allow for experiences in developing intervention programmes particularly in changing the culture of disrespect and abuse in maternity care. Using a public health facility Komfo Anokye Teaching Hospital and School in Kumasi, Ghana the overall goal of the research is to examine: 1) the feasibility of implementing respectful care modules (RMC-M) in Kumasi, Ghana; 2) whether exposure to RMC-M increases Ghanaian women’s perception of respectful maternity care in a public hospital setting in Ghana; and 3) the efficacy of RMC-M in changing midwives’ attitudes, behaviors and clinical practice patterns. To achieve Aim 1, qualitative and quantitative study designs will be used to assess for fidelity of implementation, usefulness, and patient responsiveness. Based on data collected, feasibility will be examined and the RMC-M will be further modified as needed prior to beginning Aim 2. To achieve Aim 2, a two group study design will be used, with one group of midwives receiving training on the RMC- M and the other receiving training in basic emergency obstetric care. Women receiving care from these two groups of midwives will be followed through intrapartum and surveyed postpartum to examine their perceptions of the care they received. To achieve Aim 3, a pre-post study design will examine whether expose to a RMC-M changes midwives’ attitudes, behaviors, and clinical care of women during labor and delivery.