Background: Mistreatment during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, mistreatment 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 and decrease mistreatment in three districts in Ethiopia.
Methods: As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel respectful maternity care training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the respectful maternity care 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 interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facility level solutions applied to enhance privacy and birth companion were documented.
Results: Analysis of the effectiveness of integrating respectful maternity care using available programmatic data showed significant improvement following the respectful maternity care 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.
Conclusion: This study suggests that integrating the respectful maternity care training into the district-wide quality improvement collaborative is effective in improving respectful maternity care. Multi-pronged approach is especially helpful in enhancing respectful maternity care comprehensively. Use of testimonial videos helped providers to see their services from their clients’ perspective, the quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions.
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Received 29 Dec, 2020
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Received 16 May, 2020
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Received 17 Feb, 2020
On 28 Jan, 2020
Received 28 Jan, 2020
On 26 Jan, 2020
On 17 Jan, 2020
Invitations sent on 14 Jan, 2020
On 11 Dec, 2019
On 06 Dec, 2019
On 05 Dec, 2019
Received 29 Dec, 2020
On 29 Dec, 2020
On 08 Dec, 2020
Received 20 Nov, 2020
On 15 Nov, 2020
Invitations sent on 11 Aug, 2020
On 03 Aug, 2020
On 02 Aug, 2020
On 02 Aug, 2020
Posted 30 Mar, 2020
On 02 Jun, 2020
Received 16 May, 2020
Received 05 May, 2020
On 03 May, 2020
On 30 Apr, 2020
Invitations sent on 31 Mar, 2020
On 25 Mar, 2020
On 24 Mar, 2020
On 24 Mar, 2020
On 18 Feb, 2020
Received 17 Feb, 2020
On 28 Jan, 2020
Received 28 Jan, 2020
On 26 Jan, 2020
On 17 Jan, 2020
Invitations sent on 14 Jan, 2020
On 11 Dec, 2019
On 06 Dec, 2019
On 05 Dec, 2019
Background: Mistreatment during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, mistreatment 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 and decrease mistreatment in three districts in Ethiopia.
Methods: As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel respectful maternity care training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the respectful maternity care 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 interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facility level solutions applied to enhance privacy and birth companion were documented.
Results: Analysis of the effectiveness of integrating respectful maternity care using available programmatic data showed significant improvement following the respectful maternity care 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.
Conclusion: This study suggests that integrating the respectful maternity care training into the district-wide quality improvement collaborative is effective in improving respectful maternity care. Multi-pronged approach is especially helpful in enhancing respectful maternity care comprehensively. Use of testimonial videos helped providers to see their services from their clients’ perspective, the quality improvement training and coaching helped 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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