Live experience of community health workers on respectful maternity care in rural Odisha, India: a phenomenological study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20233088Keywords:
Respectful maternity care, Healthcare providers, Perceptions, Disrespect and abuse, Mistreatment, Birth companion, ASHAAbstract
Background: Every woman deserves respectful maternity care, throughout her journey to motherhood. However, disrespectful maternity care is prevalent in various settings. It has an effect on the utilization of services. It can be more explored from the witness of maternity. The aim of this study was to explore the experience of accredited social health activists on respectful maternity care in Odisha, India.
Methods: A qualitative exploratory study was conducted among 24 ASHAs with more than two years of experience to gain a deeper understanding of the phenomenon. This study was conducted in three distinct Odisha districts, India.
Results: Two main themes emerged: Community health workers’ experiences and perception towards disrespectful care, and Factors contributing to irrational care. Participants explained that verbal abuse was the most common use of health care providers. The consequences of such abusive behavior hinder the effective and efficient performance of their role, especially when it comes to their role in the facility. The study highlighted major gaps in the behavior and attitudes of healthcare providers at the facility level.
Conclusions: Despite the lack of knowledge and training related to RMC, ASHAs acknowledged the abusive and disrespectful behavior of health care providers not only towards the child-bearing women but also towards the accompanying person, i.e., ASHA or a member of the family. Such mistreatment often acts as a barrier to the use of public health services, such as the institutional delivery of child-bearing mothers. A need for orientation and training on RCM among healthcare professionals, along with appropriate monitoring of implementation.
Metrics
References
Grove J, Claeson M, Bryce J, Amouzou, A., Boerma, T. Maternal, newborn, and child health and the Sustainable Development Goals a call for sustained and improved measurement. Lancet. 2015; 386(10003):1511-4.
Langer A, Meleis A, Knaul FM, Atun R, Aran M, Arreola-Ornelas H, et al. Women and Health: the key for sustainable development. Lancet. 2015;386(9999): 1165-210.
Mohapatra A, Gomare M. A critical appraisal of the maternal and child health scenario in a metropolitan city in India with reference to achievements of millennium development goals. J Family Med Prim Care. 2019;8(3):995-1001.
Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK, et al. State of newborn health in India. J Perinatol. 2016 Dec;36(s3):S3-8.
Fekadu GA, Kassa GM, Berhe AK, Muche AA, Katiso NA. The effect of antenatal care on use of institutional delivery service and postnatal care in Ethiopia: a systematic review and meta-analysis. BMC Health Serv Res. 2018;18(1):577.
Fink G, Ross R, Hill K. Institutional deliveries weakly associated with improved neonatal survival in developing countries: evidence from 192 Demographic and Health Surveys. Int J Epidemiol. 2015;44(6):1879-88.
Goudar SS, Goco N, Somannavar MS, Vernekar SS, Mallapur AA, Moore JL, et al. Institutional deliveries and perinatal and neonatal mortality in Southern and Central India. Reprod Health. 2015;2(2):S13.
Tura G, Fantahun M, Worku A. The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013;13:18.
Shah P, Shah S, Kutty RV, Modi D. Changing epidemiology of maternal mortality in rural India: time to reset strategies for MDG-5. Trop Med Int Health. 2014;19(5):568-75.
Srivastava A, Singh D, Montagu D, Bhattacharyya S. Putting women at the center: a review of Indian policy to address person-centered care in maternal and newborn health, family planning and abortion. BMC Public Health. 2017;18(1):20.
Syam RB. Family Welfare Programmes in India. India's J Toward Sustain Popul. 2017;3:297-312.
WHO global strategy on people-centred and integrated health services: interim report. Available at: https://www.who.int. Accessed on 20 February 2023.
Shakibazadeh E, Namadian M, Bohren MA, Vogel JP, Rashidian A, Nogueira PV, et al. Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG. 2018; 125(8):932-42.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
Chinkhumba J, De Allegri M, Muula AS, Robberstad B. Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: a meta-analysis of population-based cohort studies. BMC Public Health. 2014;14:1014.
Berhan Y, Berhan A. Skilled health personnel attended delivery as a proxy indicator for maternal and perinatal mortality: a systematic review. Ethiop J Health Sci. 2014;24:69-80.
Khanam R, Baqui AH, Syed MIM, Harrison M, Begum N, Quaiyum A, et al. Can facility delivery reduce the risk of intrapartum complications-related perinatal mortality? Findings from a cohort study. J Glob Health. 2018;8(1):010408.
Gabrysch S, Nesbitt RC, Schoeps A. Does facility birth reduce maternal and perinatal mortalityin BrongAhafo, Ghana? A secondary analysis using data on 119 244 pregnancies from two clusterrandomised controlled trials. Lancet Global Health. 2019;7(8): e1074-87.
Sidney K, Tolhurst R, Jehan K, Diwan V, De Costa A. 'The money is important but all women anyway go to hospital for childbirth nowadays' - a qualitative exploration of why women participate in a conditional cash transfer program to promote institutional deliveries in Madhya Pradesh, India. BMC Pregnancy Childbirth. 2016;16:47.
Tancred T, Marchant T, Hanson C, Schellenberg J, Manzi F. Birth preparedness and place of birth in Tandahimba district, Tanzania: what women prepare for birth, where they go to deliver, and why. BMC Pregnancy Childbirth. 2016;16(1):165.
Mason L, Dellicour S, Ter Kuile F, Ouma P, Phillips-Howard P, Were F, et al. Barriers and facilitators to antenatal and delivery care in western Kenya: a qualitative study. BMC Pregnancy Childbirth. 2015; 15:26.
Gupta SK, Pal DK, Tiwari R, Garg R, Shrivastava AK, Sarawagi R, et al. Impact of Janani Suraksha Yojana on institutional delivery rate and maternal morbidity and mortality: an observational study in India. J Health Popul Nutr. 2012;30(4):464-71.
Vellakkal S, Reddy H, Gupta A, Chandran A, Fledderjohann J, Stuckler D. A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program. Soc Sci Med. 2017;178:55-65.
Sudhinaraset M, Treleaven E, Melo J, Singh K, Diamond-Smith N. Women's status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory. BMC Pregnancy Childbirth. 2016;16(1):332.
Asefa A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health. 2015;12:33.
Sando D, Ratcliffe H, McDonald K, Spiegelman D, Lyatuu G, Mwanyika-Sando M, et al. The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy Childbirth. 2016; 16:236.
Gebremichael MW, Worku A, Medhanyie AA, Berhane Y. Mothers' experience of disrespect and abuse during maternity care in northern Ethiopia. Glob Health Action. 2018;11(3):146.
Ogunlaja A, Fehintola O, Ogunlaja I, Popoola G. Respectful Maternity Care or Disrespect and Abuse during Maternity Care: Experience of pregnant women in Ogbomoso, South West Nigeria. Rwanda Med J. 2017;74(3):6-9.
