Sen Gita, Reddy Bhavya, Iyer Aditi
a Distinguished Professor & Director , Ramalingaswami Centre on Equity & Social Determinants of Health , Public Health Foundation of India, Bangalore , India.
b Research Associate , Ramalingaswami Centre on Equity & Social Determinants of Health , Public Health Foundation of India, Bangalore , India .
Reprod Health Matters. 2018;26(53):6-18. doi: 10.1080/09688080.2018.1508173. Epub 2018 Sep 7.
Concerns about disrespect and abuse (D&A) experienced by women during institutional birth have become critical to the discourse on maternal health. The rapid growth of the field from diverse points of origin has given rise to multiple and, at times, confusing interpretations of D&A, pointing to the need for greater clarity in the concepts themselves. Furthermore, attention to measurement of the problem has been excessive when viewed in relation to the small amount of work on critical drivers of disrespect and abuse. This paper raises some key issues of conceptualisation and measurement for the field, puts forward a working definition, and explores two critical drivers of D&A - intersecting social and economic inequality, and the institutional structures and processes that frame the practice of obstetric care. By identifying gaps and raising questions about the deeper causes of D&A, we point to potentially fruitful directions for research and action.
对女性在机构分娩期间所经历的不尊重和虐待行为的担忧，已成为孕产妇健康论述的关键问题。该领域从不同起源迅速发展，引发了对不尊重和虐待行为的多种、有时甚至相互矛盾的解读，这表明需要对这些概念本身有更清晰的界定。此外，与针对不尊重和虐待行为关键驱动因素的少量研究相比，对该问题测量的关注过多。本文提出了该领域概念化和测量方面的一些关键问题，给出了一个实用定义，并探讨了不尊重和虐待行为的两个关键驱动因素——社会和经济不平等的交叉，以及构成产科护理实践的机构结构和流程。通过找出差距并对不尊重和虐待行为的深层原因提出疑问，我们指出了研究和行动可能富有成效的方向。
