在尼日利亚东南部，公立和私立医院在分娩过程中是否存在不尊重和虐待的情况有所不同。

Does disrespect and abuse during childbirth differ between public and private hospitals in Southeast Nigeria.

机构信息

Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria.

African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria.

出版信息

BMC Pregnancy Childbirth. 2021 Dec 31;21(1):852. doi: 10.1186/s12884-021-04298-z.

DOI:10.1186/s12884-021-04298-z

PMID:34972518

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8719415/

Abstract

BACKGROUND

Disrespect and Abuse (D&A) during childbirth represents an important barrier to skilled birth utilization, indicating a problem with quality of care and a violation of women's human rights. This study compared prevalence of D&A during childbirth in a public and a private hospital in Southeast Nigeria.

METHODS

This study was a cross-sectional study among women who gave birth in two specialized health facilities: a public teaching and a private-for-profit faith-based hospital in Southeast Nigeria. In each facility, systematic random sampling was used to select 310 mothers who had given birth in the facility and were between 0-14 weeks after birth. Study participants were recruited through the immunization clinics. Semi-structured, interviewer-administered questionnaires using the Bowser and Hills classification of D&A during childbirth were used for data collection. Data were analyzed using SPSS version 20 at 95% significance level.

RESULTS

Mean age of the participants in the public hospital was 30.41 ± 4.4 and 29.31 ± 4.4 in the private hospital. Over three-fifths (191; 61.6%) in the public and 156 women (50.3%) in the private hospital had experienced at least one form of D&A during childbirth [cOR1.58; 95% CI 1.15, 2.18]. Abandonment and neglect [Public153 (49.4%) vs. Private: 91 (29.4%); cOR2.35; 95% CI. 1.69, 3.26] and non-consented care [Public 45 (14.5%) vs. Private 67(21.6%): cOR0.62; 95% CI. 0.41, 0.93] were the major types of D&A during childbirth. Denial of companionship was the most reported subtype of D&A during childbirth in both facilities [Public 135 (43.5%) vs. Private66 (21.3%); cOR2.85; 95% CI. 2.00, 4.06]. Rural residents were less likely to report at least one form of D&A during childbirth (aOR 0.53; CI 0.35-0.79).

CONCLUSION

Although prevalence was high in both facilities, overall prevalence of D&A during childbirth and most subtypes were higher in the public health facility. There is a need to identify contextual factors enabling D&A during childbirth in public and private health care settings.

摘要

背景

分娩过程中的不尊重和虐待（D&A）是熟练分娩利用的一个重要障碍，表明存在护理质量问题和侵犯妇女人权的问题。本研究比较了尼日利亚东南部一家公立和一家私立营利性信仰医院分娩过程中 D&A 的发生率。

方法

这是一项在尼日利亚东南部两家专门医疗设施中的妇女中进行的横断面研究：一家公立教学医院和一家私立营利性信仰医院。在每个设施中，使用系统随机抽样选择 310 名在设施中分娩且分娩后 0-14 周的母亲。研究参与者通过免疫接种诊所招募。使用 Bowser 和 Hills 分娩期间 D&A 分类的半结构式访谈者管理问卷进行数据收集。使用 SPSS 版本 20 在 95%的显着性水平下分析数据。

结果

公立医院参与者的平均年龄为 30.41 ± 4.4，私立医院为 29.31 ± 4.4。在公立医院，超过五分之三（191 名；61.6%）和私立医院的 156 名妇女（50.3%）在分娩期间至少经历过一种形式的 D&A [校正比值比（cOR）1.58；95%置信区间（CI）1.15，2.18]。遗弃和忽视[公立医院 153 名（49.4%）与私立医院：91 名（29.4%）；cOR2.35；95% CI. 1.69, 3.26]和未经同意的护理[公立医院 45 名（14.5%）与私立医院 67 名（21.6%）：cOR0.62；95% CI. 0.41, 0.93]是分娩期间 D&A 的主要类型。拒绝陪伴是两家医院分娩期间报告最多的 D&A 亚型[公立医院 135 名（43.5%）与私立医院 66 名（21.3%）：cOR2.85；95% CI. 2.00, 4.06]。农村居民报告分娩期间至少一种 D&A 的可能性较低（校正比值比（aOR）0.53；CI 0.35-0.79）。