Effect of person-centered intervention on women's knowledge and attitude towards obstetric violence during facility childbirth in southwest Ethiopia: a quasi-experimental study.

BACKGROUND

Obstetric violence (OV) constitutes a serious violation of women's rights and represents a form of gender-based violence. This abuse not only undermines women's dignity but also poses significant risks to their health and overall well-being. Many women lack awareness of their rights during childbirth, and this gap in knowledge, coupled with unfavorable attitudes toward the issue, allows obstetric violence to persist and become entrenched within healthcare systems. The normalization of such behavior among both healthcare providers and women themselves further exacerbates the prevalence of obstetric violence. A review of existing literature reveals a notable scarcity of studies employing experimental designs to evaluate the impact of interventions on women's knowledge and attitudes regarding obstetric violence. Consequently, this study aims to assess the effectiveness of a person-centered intervention in enhancing women's understanding and attitudes toward obstetric violence among those who have given birth in public hospitals in southwest Ethiopia.

METHODS

A quasi-experimental study with a control group was conducted in public hospitals in southwest Ethiopia, involving a randomly selected sample of 396 postpartum women (198 in the control group and 198 in the intervention group). A person-centered intervention comprising a respectful maternity care workshop, maternity open days, and the provision of maternal certificates of recognition was implemented for the 198 women in the intervention group, while the control group received standard care. The chi-square test, independent t-test, and paired sample t-test were used to analyze differences between and within the groups, respectively. Additionally, a generalized linear regression model was employed to determine the effect size of the intervention on women's knowledge and attitudes, adjusting for background variables.

RESULTS

The mean scores for women's knowledge significantly improved in the intervention group, increasing from 14.82 ± 7.08 to 19.17 ± 5.25 (P < 0.001). A paired t-test revealed a significant difference (P < 0.001) between the pre-test and post-test scores within the intervention group. Furthermore, an independent t-test showed a significant difference in all aspects of knowledge between the intervention and control groups in the post-test (P < 0.001), whereas no significant difference was observed during the pre-test stage for either group (P > 0.05). On average, women who received the person-centered intervention scored 4.13 points higher in their understanding of rights compared to those in the control group. The study also highlighted a significant difference in women's attitudes toward obstetric violence between the experimental and control groups after the intervention, with scores of 21.80 ± 5.43 for the intervention group and 32.65 ± 7.40 for the control group (P < 0.01). Additionally, being part of the intervention group reduced women's unfavorable attitudes nearly elevenfold (β = -10.81, 95% CI = -12.17, -9.45). Women's knowledge increased by an average of four points (β = 4.21, 95% CI = 2.98, 5.43) in the intervention group compared to the control group.

CONCLUSIONS

The findings demonstrated that implementing a person-centered intervention significantly enhanced women's knowledge and decreased unfavorable attitudes toward obstetric violence, ultimately promoting respectful maternal care. Therefore, we recommend adopting and integrating such interventions into existing maternal health programs in Ethiopia to strengthen maternal health initiatives.

CLINICAL TRIAL NUMBER

Not applicable.