Habib Helen H, Torpey Kwasi, Maya Ernest Tei, Ankomah Augustine
Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Population Council Ghana, Accra, Ghana.
Reprod Health. 2020 Aug 24;17(1):129. doi: 10.1186/s12978-020-00977-w.
Intra-partum mistreatment by healthcare providers remains a global public health and human rights challenge. Adolescents, who are typically younger, poorer and less educated have been found to be disproportionately exposed to intra-partum mistreatment. In Ghana, maternal mortality remains a leading cause of death among adolescent females, despite increasing patronage of skilled birth attendance in health facilities. In response to the the World Health Organisation Human Reproduction Programme (WHO-HRP) recommendations to address mistreatment with Respectful Maternity Care (RMC), this study aims to generate evidence on promoting respectful treatment of adolescents using an intervention that trains health providers on the concept of mistreatment, their professional roles in RMC and the rights of adolescents to RMC.
This study will employ a pre-test post-test quasi-experimental design. At pre-test and post-test, quantitative surveys will be conducted among adolescents who deliver at health facilities about their labour experience with mistreatment and RMC. A total target of 392 participants will be recruited across intervention and control facilities. Qualitative interviews will also be conducted with selected adolescents and health professionals for an in-depth understanding of the phenomenon. Following the pre-test, a facility-based training module will be implemented at intervention facilities for the facility midwives. The modules will be co-facilitated by the principal investigator and key resource persons from the district health directorate Quality of Care teams. Training will cover the rights of adolescents to quality healthcare, classifications of mistreatment, RMC as a concept and the role of professionals in providing RMC. No intervention will occur in the control facilities. Descriptive statistics, logistic regressions and difference in differences analyses will be computed. Qualitative data will be transcribed and thematically analysed.
This study is designed to test the success of an intervention in promoting RMC and reducing intra-partum mistreatment towards adolescents. It is expected that the findings of this study will be beneficial in adding to the body of knowledge in improving maternal healthcare and reducing maternal mortality, especially for adolescents.
Name of the registry: Pan African Clinical Trials Registry. PACTR202008781392078 .
医疗服务提供者在分娩期间的虐待行为仍然是一项全球性的公共卫生和人权挑战。研究发现,青少年通常更年轻、更贫困且受教育程度更低,他们遭受分娩期虐待的比例过高。在加纳,尽管在医疗机构中接受专业助产服务的人数有所增加,但孕产妇死亡率仍是青春期女性死亡的主要原因。为响应世界卫生组织人类生殖计划(WHO-HRP)提出的采用尊重孕产妇护理(RMC)来解决虐待问题的建议,本研究旨在通过一项干预措施来收集证据,该干预措施旨在培训医疗服务提供者了解虐待的概念、他们在RMC中的专业角色以及青少年获得RMC的权利,从而促进对青少年的尊重对待。
本研究将采用前测后测准实验设计。在前测和后测时,将对在医疗机构分娩的青少年进行关于其分娩经历中虐待和RMC情况的定量调查。将在干预设施和对照设施中总共招募392名参与者。还将对选定的青少年和医疗专业人员进行定性访谈,以深入了解这一现象。在前测之后,将在干预设施中为设施助产士实施一个基于设施的培训模块。这些模块将由首席研究员和地区卫生局护理质量团队的关键资源人员共同推动。培训将涵盖青少年获得优质医疗保健的权利、虐待的分类、RMC的概念以及专业人员在提供RMC方面的作用。对照设施将不进行任何干预。将计算描述性统计数据、逻辑回归和差异分析。定性数据将进行转录并进行主题分析。
本研究旨在测试一项干预措施在促进RMC和减少对青少年的分娩期虐待方面的成效。预计本研究的结果将有助于增加在改善孕产妇医疗保健和降低孕产妇死亡率方面的知识体系,特别是对于青少年而言。
注册机构名称:泛非临床试验注册中心。注册号:PACTR202008781392078 。