埃塞俄比亚公共卫生机构中的妇女受虐待问题。
Mistreatment of women in public health facilities of Ethiopia.
机构信息
Jhpiego Ethiopia, Addis Ababa, Ethiopia.
Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Global Health, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands.
出版信息
Reprod Health. 2019 Aug 27;16(1):130. doi: 10.1186/s12978-019-0781-y.
BACKGROUND
Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors.
METHODS
A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling.
RESULTS
A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028).
CONCLUSION
Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.
背景
最近的证据表明，分娩过程中对妇女的虐待是医疗保健系统面临的全球性挑战。本研究旨在探讨埃塞俄比亚公立医疗机构中妇女受虐待的普遍程度，并确定相关因素。
方法
采用两阶段横断面抽样设计选择机构和妇女。该研究在埃塞俄比亚四个地区的医院和保健中心进行。从产后妇女收集定量数据。使用四个领域衡量虐待行为：（1）身体虐待，（2）言语虐待，（3）未能达到专业护理标准，（4）妇女与提供者之间关系不佳。使用单变量和多变量逻辑回归模型计算虐待存在与妇女机构和社会人口学特征之间的关联的存在率和比值比。
结果
共采访了 379 名妇女，其中 281 名（74%）报告了任何形式的虐待。接受采访的妇女中，有 7 人（2%）和 31 人（8%）报告了身体和言语虐待。有 111 名（29%）和 274 名（72%）接受采访的妇女分别报告了未能达到专业护理标准和妇女与提供者之间关系不佳。多变量逻辑回归分析表明，与无生育史的妇女相比，有 4 次及以上生育史的妇女报告虐待的几率更高（aOR=3.36 95%CI 1.22,9.23, p=0.019），与穆斯林妇女相比（aOR=3.30 95%CI 1.4,7.77, p=0.006），与每个月每 17 名产妇以下的母婴健康工作人员的设施中接受采访的妇女相比（aOR=3.63 95%CI 1.9,6.93, p<0.001）。然而，年龄在 35 岁及以上的妇女报告虐待的几率较低（aOR=0.22 95%CI 0.06, 0.73, p=0.014），产后 8 至 42 天接受采访的妇女报告虐待的几率较低（aOR=0.37 95%CI 0.15, 0.9, p=0.028）。
结论
埃塞俄比亚分娩期间的虐待行为普遍存在。卫生工作者需要考虑为妇女提供个性化护理，并监测她们的体验，以调整服务质量。
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