Respectful maternity care and associated factors among mothers who gave birth at public health institutions in South Gondar Zone, Northwest Ethiopia 2021

Abstract

Introduction: Respectful maternity care is essential for improving maternal and neonatal health. Lack of respectful maternity care during childbirth services is one of the deterrents to women seeking facility-based deliveries. It is a health system failure and a violation of women's rights. There is limited data on respectful maternity care during childbirth and maternity care in Ethiopia, particularly at rural health facilities. But studies have shown that many women from rural areas were more likely to report disrespect and abuse than urban residents.

Objective: This study aims to assess respectful maternity care and associated factors among mothers who gave birth at health institutions in the South Gondar zone, northwest Ethiopia, 2021.

Methods: A multicenter institutional-based cross-sectional study design was conducted among mothers who gave birth at South Gondar Zone public health institutions, from 1 February to 30 March 2021. Six hundred twenty-two study participants were selected by using systematic random sampling. The data were collected through face-to-face interviews using a pretested and semi-structured questionnaire. Data were entered into Epi-Data version 4.6 and exported to SPSS version 23 for analysis. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance.

Result: A total of 611 participants were included in the study with the response rate of 98.2%. The study revealed that only 39.4%, of (95% confidence interval: 35.4-43.2) women received respectful maternity care. Completed secondary education (adjusted odds ratio: 2.47, 95% confidence interval: 1.35-4.50), having antenatal care follow-up (adjusted odds ratio: 0.098, 95% confidence interval: 0.03-0.34), planned pregnancy (adjusted odds ratio: 3.21, 95% confidence interval: 1.69-6.08), cesarean section delivery (adjusted odds ratio: 0.47, 95% confidence interval: 0.25-0.89), and daytime delivery (adjusted odds ratio: 1.9, 95% confidence interval: 1.33-2.72)) were significantly associated with respectful maternity care.

Conclusion and recommendation: Only two out of five women received respectful maternity care during childbirth. Completed secondary education, having antenatal care follow-up, pregnancy intended/wanted, daytime delivery, and cesarean section delivery were identified factors. Therefore, giving emphasis to creating awareness of care providers on the standards and categories of respectful maternity care, improving care provider-client discussion, monitoring, and reinforcing accountability mechanisms for health workers to improve respectful maternity care during labor and childbirth were recommended.

Keywords: labor and childbirth; public health institutions; respectful maternity care; south Gondar zone.

Figure 1.

Prevalence of different categories of RMC during childbirth at public health institutions in the South Gondar Zone, Amhara region, Northwest Ethiopia, 2021.