This study aimed to assess the proportion of respectful delivery care and associated factors among mothers delivered in Debre Berhan town public health facilities. The proportion of respectful delivery care in this study was 35.7%. This is nearly similar to the cross-sectional studies done in four regions and Bahir Dar, Ethiopia which were reported that 36% and 32.9% of mothers were received respectful delivery care during facility childbirth respectively [29, 38].
On the contrary, it was lower than the cross-sectional studies conducted in Brazil 81.7% , Nigeria 81% , and Ethiopia 78% . This discrepancy might be due to socio-cultural, economic status, health policy variation, study setting difference, and different measurement tools. However, this was higher than the study conducted in Addis Ababa (21.4%), Jimma (8.3%), Wollega (25.2%), and Gondar (24.6%), Ethiopia [26, 31–33]. It could be due to that the previous study was before the government of Ethiopia initiates the CRC program. But, now basic supportive training is given for all maternal health service providers.
This study showed that mothers who had a companion during delivery were 2.45 times more likely received respectful delivery care than mothers who had no companion. This finding is consistent with the studies conducted in Tigray and Wollega, Ethiopia [27, 33]. The possible reason could be due to mothers who had a companion might be improving the mother’s confidence and reduce labor-related stress due to emotional and psychological support by their companion. Besides, providers might refrain from abusive behaviors due to fear of companion, the companion also assisting providers and assisting mother’s decision making.
On the contrary, an observational study conducted in four regions of Ethiopia public health facilities reported that mothers who had a companion during delivery care had an insignificant association with respectful delivery care . This might be due to different study settings, a small sample size of former study, and study period variation.
In this study mothers who had delivered during day time were 2.48 times more likely to received respectful delivery care than delivered at night time. This finding is consistent with the studies conducted in Kenya and Ethiopia Bahir Dar [30, 41]. The possible reason for this association might be due to sleeping disturbance of provider, workload, and poor infrastructure of the facility (electric power interruption) during night time delivery.
On the contrary, an observational study conducted in Ethiopia four rural health centers reported that weekend delivered mothers were twenty times more likely received disrespectful delivery care than night time delivery . This contradiction might be due to different data collection methods (observational), study setting and study period variation.
Mothers who had secondary or more educational status were nearly four times more likely to received respectful delivery care than formally non-educated mothers. This is in line with the study conducted in Arba Minch, Ethiopia . The possible reason for this association could be educated mothers might have relatively good knowledge about their rights and obligation in the health facilities. Besides, they might have good rapport building with the provider due to nearly similar level education status, and better health-seeking behaviors that help, providers develop a good attitude toward them.
However, the studies conducted in Tigray and Jimma, Ethiopia reported that secondary and more educated mothers were 1.5 and 3 times more likely disrespected than illiterate mothers [27, 31]. This inconsistency in Tigray study might be due to differences in study setting that was a community-based study within one year of delivery which might be affected by recall bias and study period variation. Similarly, the study conducted in Jimma had a small sample size and study population variation that excludes mothers who gave birth via C-section.
In this study mothers who had four or more ANC follow-up were 2.54 times more likely to received respectful delivery care than mothers who had less than four ANC follow-up. This is agreed with the study done in Bahir Dar which was reported a positive significant association . This could be due to a woman who had more ANC visits that might have better health-seeking behaviors and health workers might have a positive attitude for women who had more ANC follow-up. On the contrary, the studies done in Pakistan and Ethiopia showed an insignificant association between respectful delivery care and ANC visits [38, 42]. The reason for this discrepancy might be different study settings, different health policies, and socio-cultural variations.