服务提供者在埃塞俄比亚亚的斯亚贝巴的医疗机构分娩过程中经历的针对妇女的不尊重和虐待行为。
Service providers' experiences of disrespectful and abusive behavior towards women during facility based childbirth in Addis Ababa, Ethiopia.
机构信息
School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, P.O.Box 70, Hawassa, Ethiopia.
Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne, Level 5, 333 Exhibition Street, Melbourne, 3000, Australia.
出版信息
Reprod Health. 2018 Jan 5;15(1):4. doi: 10.1186/s12978-017-0449-4.
BACKGROUND
Disrespect and abuse (D&A) of women during childbirth by the attending staff in health facilities has been widely reported in many countries. Although D&A in labor rooms is recognized as a deterrent to maternal health service utilization, approaches to defining, classifying, and measuring D&A are still at an early stage of development. This study aims to enhance understanding of service providers' experiences of D&A during facility based childbirth in health facilities in Addis Ababa.
METHODS
A facility based cross-sectional study was conducted in August 2013 in one hospital and three health centers. A total of 57 health professionals who had assisted with childbirth during the study period completed a self-administered questionnaire. Service providers' personal observations of mistreatment during childbirth and their perceptions of respectful maternity care (RMC) were assessed. Data were entered into and analyzed using SPSS version 16 software.
RESULTS
The majority (83.7%) of participants were aged <30 years (mean = 27.25 ± 5.45). Almost half (43.9%) were midwives, and 77.2% had less than five years experience as a health professional. Work load was reported to be very high by 31.6% of participants, and 28% rated their working environment as poor or very poor. Almost half (50.3%) of participants reported that service providers do not generally obtain women's consent prior to procedures. One-quarter (25.9%) reported having ever witnessed physical abuse (physical force, slapping, or hitting) in their health facility. They also reported observing privacy violations (34.5%), and women being detained against their will (18%). Violations of women's rights were self-reported by 14.5% of participants. More than half (57.1%) felt that they had been disrespected and abused in their work place. The majority of participants (79.6%) believed that lack of respectful care discourages pregnant women from coming to health facilities for delivery.
CONCLUSIONS
The study findings indicate that most service providers from these facilities had witnessed disrespectful practices during childbirth, and recognized that such practices have negative consequences for service utilization. These findings can help decision makers plan for interventions to improve RMC taking account of the provider perspective.
背景
在许多国家，医疗机构工作人员在分娩过程中对妇女的不尊重和虐待（D&A）已被广泛报道。尽管分娩室中的 D&A 被认为是阻碍孕产妇保健服务利用的因素，但定义、分类和衡量 D&A 的方法仍处于早期发展阶段。本研究旨在增进人们对医疗机构中分娩期间服务提供者经历的理解。
方法
2013 年 8 月，在一家医院和三家保健中心进行了一项基于设施的横断面研究。在研究期间协助分娩的 57 名卫生专业人员完成了一份自我管理的问卷。评估了服务提供者在分娩过程中个人观察到的虐待行为以及他们对尊重产妇护理（RMC）的看法。数据输入并使用 SPSS 版本 16 软件进行分析。
结果
大多数参与者（83.7%）年龄<30 岁（平均 27.25±5.45 岁）。将近一半（43.9%）是助产士，77.2%的人作为卫生专业人员的经验不足五年。31.6%的参与者报告工作负荷非常大，28%的人将工作环境评为差或很差。近一半（50.3%）的参与者报告说，服务提供者通常在程序前未获得妇女的同意。四分之一（25.9%）的人报告说，在他们的卫生机构中曾经目睹过身体虐待（身体暴力、掌掴或殴打）。他们还报告说观察到侵犯隐私（34.5%）和妇女被违背意愿拘留（18%）。14.5%的参与者报告了侵犯妇女权利的行为。超过一半（57.1%）的人认为他们在工作场所受到了不尊重和虐待。大多数参与者（79.6%）认为缺乏尊重性护理会阻止孕妇到医疗机构分娩。
结论
研究结果表明，这些机构的大多数服务提供者在分娩过程中目睹了不尊重的行为，并认识到这种行为对服务利用有负面影响。这些发现可以帮助决策者规划干预措施，以改善 RMC，同时考虑到提供者的观点。
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