See the published version of this preprint at BMC Pregnancy and Childbirth.
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Research article
Birkety Mengistu Jembere
Institute for Healthcare Improvement
Corresponding Author
License:
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Background
Disrespect and abuse (D&A) during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, D&A has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care (RMC) and decrease D&A in three districts in Ethiopia.
Methods
As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel RMC training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the RMC training in three districts within the regions of Oromia; Southern Nations, Nationalities, and People’s; and Tigray. Measures of births with privacy and a birth companion from a 27-month data from 17 health centers and three hospitals were analyzed using STATA version 13 for interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facilitated discussions were conducted among health care providers to gauge the effectiveness of the videos. Facility level solutions applied to enhance RMC were documented.
Results
An analysis of the effectiveness of integrating RMC using available programmatic data showed significant improvement following the RMC training, which was sustained beyond the project intervention (regression coefficients ranging from 0.18 to 0.77). Several local solutions were devised and implemented in the health facilities to improve the experience of care for mothers. Facilitated discussions with health care providers participating in the RMC training showed improved understanding of patients’ perspectives and the psychosocial needs of their clients.
Conclusion
This study suggests that integrating the RMC training into the district-wide quality improvement (QI) collaborative is effective in improving RMC. Use of testimonial videos are especially helpful as they remind providers of the need to treat mothers with dignity and helps them reflect on potential root causes for this type of treatment and develop effective solutions.
Keywords
Disrespect and abuse, Respectful maternity care, Quality improvement, Childbirth, Compassionate respectful care, Patient-centeredness, Experience of care, Ethiopia
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CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Review #2 received
Received 29 Dec, 2020
Editorial decision: Major revision
On 29 Dec, 2020
Reviewer #2 agreed
On 08 Dec, 2020
Review #1 received
Received 20 Nov, 2020
Reviewer #1 agreed
On 15 Nov, 2020
Reviewers invited
Invitations sent on 11 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
No comments provided
Editorial decision: Major revision
On 02 Jun, 2020
Review #1 received
Received 16 May, 2020
Review #2 received
Received 05 May, 2020
Reviewer #2 agreed
On 03 May, 2020
Reviewer #1 agreed
On 30 Apr, 2020
Reviewers invited
Invitations sent on 31 Mar, 2020
Editor assigned
On 25 Mar, 2020
Submission checks complete
On 24 Mar, 2020
Editor invited
On 24 Mar, 2020
Version 1
Posted 11 Dec, 2019
No comments provided
Editorial decision: Major revision
On 18 Feb, 2020
Review #2 received
Received 17 Feb, 2020
Reviewer #3 agreed
On 28 Jan, 2020
Review #1 received
Received 28 Jan, 2020
Reviewer #2 agreed
On 26 Jan, 2020
Reviewer #1 agreed
On 17 Jan, 2020
Reviewers invited
Invitations sent on 14 Jan, 2020
Editor assigned
On 11 Dec, 2019
Submission checks complete
On 06 Dec, 2019
Editor invited
On 05 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Birkety Mengistu Jembere
Institute for Healthcare Improvement
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Review #2 received
Received 29 Dec, 2020
Editorial decision: Major revision
On 29 Dec, 2020
Reviewer #2 agreed
On 08 Dec, 2020
Review #1 received
Received 20 Nov, 2020
Reviewer #1 agreed
On 15 Nov, 2020
Reviewers invited
Invitations sent on 11 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
No comments provided
Editorial decision: Major revision
On 02 Jun, 2020
Review #1 received
Received 16 May, 2020
Review #2 received
Received 05 May, 2020
Reviewer #2 agreed
On 03 May, 2020
Reviewer #1 agreed
On 30 Apr, 2020
Reviewers invited
Invitations sent on 31 Mar, 2020
Editor assigned
On 25 Mar, 2020
Submission checks complete
On 24 Mar, 2020
Editor invited
On 24 Mar, 2020
Version 1
Posted 11 Dec, 2019
No comments provided
Editorial decision: Major revision
On 18 Feb, 2020
Review #2 received
Received 17 Feb, 2020
Reviewer #3 agreed
On 28 Jan, 2020
Review #1 received
Received 28 Jan, 2020
Reviewer #2 agreed
On 26 Jan, 2020
Reviewer #1 agreed
On 17 Jan, 2020
Reviewers invited
Invitations sent on 14 Jan, 2020
Editor assigned
On 11 Dec, 2019
Submission checks complete
On 06 Dec, 2019
Editor invited
On 05 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
Background
Disrespect and abuse (D&A) during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, D&A has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care (RMC) and decrease D&A in three districts in Ethiopia.
Methods
As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel RMC training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the RMC training in three districts within the regions of Oromia; Southern Nations, Nationalities, and People’s; and Tigray. Measures of births with privacy and a birth companion from a 27-month data from 17 health centers and three hospitals were analyzed using STATA version 13 for interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facilitated discussions were conducted among health care providers to gauge the effectiveness of the videos. Facility level solutions applied to enhance RMC were documented.
Results
An analysis of the effectiveness of integrating RMC using available programmatic data showed significant improvement following the RMC training, which was sustained beyond the project intervention (regression coefficients ranging from 0.18 to 0.77). Several local solutions were devised and implemented in the health facilities to improve the experience of care for mothers. Facilitated discussions with health care providers participating in the RMC training showed improved understanding of patients’ perspectives and the psychosocial needs of their clients.
Conclusion
This study suggests that integrating the RMC training into the district-wide quality improvement (QI) collaborative is effective in improving RMC. Use of testimonial videos are especially helpful as they remind providers of the need to treat mothers with dignity and helps them reflect on potential root causes for this type of treatment and develop effective solutions.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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