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

摘要 这个项目的长期职业目标是让申请者成为一名独立的研究人员并获得 独立设计和实施与改善健康结果相关的项目和计划的技能 (主要针对母亲和新生儿)在加纳和撒哈拉以南非洲地区。职业生涯发展 目标实现以下目标：1)增加设计和开展评价研究的知识 低资源环境；2)提高高级定性方法的技能；3)建设研究能力/高级 量化方法；4)与全球妇幼保健科学家建立网络；5) 将研究成果转化为实践指南和政策；6)获得负责任的行为方面的知识 研究；以及7)发展候选人的学术生涯，并确保获得高级教职。 职业生涯计划的重点是在加纳大学莱贡大学、密歇根大学和 北卡罗来纳大学。此外，还有时间参与和在科学会议上发表演讲。 会议、研讨会和会议。加纳的导师Peter Donkor博士是有史以来第一位 夸梅·恩克鲁马科技大学负责扩大研究支持 基础设施。美国导师乔迪·洛里博士在妇幼保健领域和 在加纳与助产士一起工作。她将参与研究和培训的方方面面 计划。该研究项目将提供制定干预方案的经验，特别是在 改变产妇护理中的不尊重和虐待文化。 利用加纳库马西的Komfo Anokye教学医院和学校的公共卫生设施，总体目标是 本研究旨在检验：1)在库马西实施尊重关怀模块(RMC-M)的可行性， 加纳；2)接触RMC-M是否增加了加纳妇女对尊重产妇护理的看法 在加纳的公立医院中；3)RMC-M在改变助产士态度、行为方面的有效性 和临床实践模式。为实现目标1，将采用定性和定量研究设计 评估实施的保真度、有用性和患者响应能力。根据收集的数据， 将审查可行性，并将在开始目标2之前根据需要进一步修改RMC-M。 实现目标2，将采用两组研究设计，一组助产士接受关于 RMC-M和另一名接受基本紧急产科护理培训。接受这些护理的妇女 两组助产士将在产中和产后接受跟踪调查，以检查他们的 对他们所受到的护理的看法。为了达到目标3，研究前的设计将检查是否暴露 RMC-M改变了助产士在分娩和分娩期间的态度、行为和临床护理。

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.