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Disrespect and abuse during facility-based childbirth in southern Mozambique: a cross-sectional study

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Abstract
Background: Evidence suggests that many women experience mistreatment during childbirth in health facilities across the world, but the magnitude of the problem is unknown. The occurrence of disrespect and abuse (D&A) in maternity care services affects the overall quality of care and may undermine women's trust in the health system. Studies about the occurrence of disrespect and abuse in Mozambican health facilities are scarce. The aim of this study was to explore the experience of women giving birth in hospital in different settings in Maputo City and Province, Mozambique. Methods: A cross sectional descriptive survey was conducted between April and June 2018 in the Central Hospital of Maputo (HCM) and district hospitals of Manhica and Marracuene, Maputo Province, Mozambique. Five hundred seventy-two exit interviews were conducted with women leaving the hospital after delivery. The questionnaire consisted of the following components: socio-demographic characteristics, the occurrence of disrespect and abuse, male involvement during labor and childbirth and intrapartum family planning counselling and provision. Results: Prevalence of disrespect and abuse ranged from 24% in the central hospital to 80% in the district hospitals. The main types of D&A reported were lack of confidentiality/privacy, being left alone, being shouted at/scolded, and being given a treatment without permission. While very few women's partners attended the births, the majority of women (73-80%) were in favor of involving their partner as a birth companion. Intrapartum counseling of family planning was very low (9-17%). Conclusion: The occurrence of disrespect and abuse was much higher in the district hospitals compared to the central hospital, emphasizing the high need for interventions outside Maputo City. Allowing male partners as birth companions should be explored further, as women seem in favor of involving their partners. Investing in intrapartum counselling for family planning is currently a missed opportunity for improving the uptake of contraception in the country.
Keywords
MATERNITY CARE, HEALTH, INTERVENTIONS, QUALITY, TANZANIA, Disrespect and abuse, Mozambique, Quality of care, Maternal health, Family planning, Male involvement

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MLA
Galle, Anna, et al. “Disrespect and Abuse during Facility-Based Childbirth in Southern Mozambique: A Cross-Sectional Study.” BMC PREGNANCY AND CHILDBIRTH, vol. 19, no. 1, 2019.
APA
Galle, A., Manaharlal, H., Cumbane, E., Picardo, J., Griffin, S., Osman, N., … Degomme, O. (2019). Disrespect and abuse during facility-based childbirth in southern Mozambique: a cross-sectional study. BMC PREGNANCY AND CHILDBIRTH, 19(1).
Chicago author-date
Galle, Anna, Helma Manaharlal, Emidio Cumbane, Joelma Picardo, Sally Griffin, Nafissa Osman, Kristien Roelens, and Olivier Degomme. 2019. “Disrespect and Abuse during Facility-Based Childbirth in Southern Mozambique: A Cross-Sectional Study.” BMC PREGNANCY AND CHILDBIRTH 19 (1).
Chicago author-date (all authors)
Galle, Anna, Helma Manaharlal, Emidio Cumbane, Joelma Picardo, Sally Griffin, Nafissa Osman, Kristien Roelens, and Olivier Degomme. 2019. “Disrespect and Abuse during Facility-Based Childbirth in Southern Mozambique: A Cross-Sectional Study.” BMC PREGNANCY AND CHILDBIRTH 19 (1).
Vancouver
1.
Galle A, Manaharlal H, Cumbane E, Picardo J, Griffin S, Osman N, et al. Disrespect and abuse during facility-based childbirth in southern Mozambique: a cross-sectional study. BMC PREGNANCY AND CHILDBIRTH. 2019;19(1).
IEEE
[1]
A. Galle et al., “Disrespect and abuse during facility-based childbirth in southern Mozambique: a cross-sectional study,” BMC PREGNANCY AND CHILDBIRTH, vol. 19, no. 1, 2019.
@article{8634679,
  abstract     = {Background: Evidence suggests that many women experience mistreatment during childbirth in health facilities across the world, but the magnitude of the problem is unknown. The occurrence of disrespect and abuse (D&A) in maternity care services affects the overall quality of care and may undermine women's trust in the health system. Studies about the occurrence of disrespect and abuse in Mozambican health facilities are scarce. The aim of this study was to explore the experience of women giving birth in hospital in different settings in Maputo City and Province, Mozambique.
Methods: A cross sectional descriptive survey was conducted between April and June 2018 in the Central Hospital of Maputo (HCM) and district hospitals of Manhica and Marracuene, Maputo Province, Mozambique. Five hundred seventy-two exit interviews were conducted with women leaving the hospital after delivery. The questionnaire consisted of the following components: socio-demographic characteristics, the occurrence of disrespect and abuse, male involvement during labor and childbirth and intrapartum family planning counselling and provision.
Results: Prevalence of disrespect and abuse ranged from 24% in the central hospital to 80% in the district hospitals. The main types of D&A reported were lack of confidentiality/privacy, being left alone, being shouted at/scolded, and being given a treatment without permission. While very few women's partners attended the births, the majority of women (73-80%) were in favor of involving their partner as a birth companion. Intrapartum counseling of family planning was very low (9-17%).
Conclusion: The occurrence of disrespect and abuse was much higher in the district hospitals compared to the central hospital, emphasizing the high need for interventions outside Maputo City. Allowing male partners as birth companions should be explored further, as women seem in favor of involving their partners. Investing in intrapartum counselling for family planning is currently a missed opportunity for improving the uptake of contraception in the country.},
  articleno    = {369},
  author       = {Galle, Anna and Manaharlal, Helma and Cumbane, Emidio and Picardo, Joelma and Griffin, Sally and Osman, Nafissa and Roelens, Kristien and Degomme, Olivier},
  issn         = {1471-2393},
  journal      = {BMC PREGNANCY AND CHILDBIRTH},
  keywords     = {MATERNITY CARE,HEALTH,INTERVENTIONS,QUALITY,TANZANIA,Disrespect and abuse,Mozambique,Quality of care,Maternal health,Family planning,Male involvement},
  language     = {eng},
  number       = {1},
  pages        = {13},
  title        = {Disrespect and abuse during facility-based childbirth in southern Mozambique: a cross-sectional study},
  url          = {http://dx.doi.org/10.1186/s12884-019-2532-z},
  volume       = {19},
  year         = {2019},
}

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