Muhayimana Alice, Kearns Irene Josephine, Nkurunziza Aimable, Tengera Olive, Muteteli Claudine, Bagweneza Vedaste, Umubyeyi Pacifique, Uwase Aline
Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda.
BMC Pregnancy Childbirth. 2025 Jul 2;25(1):693. doi: 10.1186/s12884-025-07804-9.
Over the past decade, global public health has increasingly focused on studying the mistreatment towards women during facility-based childbirth. However, in Rwanda, research on disrespectful and abusive care experienced by mothers during childbirth remains limited. This study aimed to assess disrespect and abuse experienced by women during their recent childbirth at a selected district hospital in Kigali, Rwanda.
We conducted a cross-sectional study in a selected urban district hospital in Kigali, Rwanda. We employed systematic random sampling to select 246 mothers who recently delivered at the study site and had been discharged from the hospital but were still on the premises. We utilised descriptive statistics and calculated a summation score of nine items of disrespect and abuse to determine our outcome of interest. Subsequently, we dichotomised the outcome. Additionally, we employed chi-square analysis and logistic regression to identify predictors of disrespect and abuse.
The prevalence of disrespect and abuse was 67.48%. During the follow-up questions, 28.86% of participants reporting experiencing disrespect and abuse once and 32.52% reporting experiencing it two to eight times. Participants experienced disrespect and abuse between one and eight times. The most prevalent forms of disrespect and abuse experienced were; abandonment (n = 77), undignified care (n = 76), and lack of information on received care (n = 65). The unadjusted logistic analysis indicated that gravida 3 was significantly associated with disrespect and abuse, with a P-value of 0.022 and a crude odds ratio of 3.2 (95% CI: 1.18-9.08). However, after adjusting for other variables, this association was no longer statistically significant, as reflected by an adjusted odds ratio with P-value of 0.061.
Our study revealed the high rate of disrespect and abuse towards women during labour and childbirth. Disrespect and abuse remains a significant issue in our study setting, emphasising the need for interventions to mitigate this problem by enhancing accountability mechanisms among healthcare providers working in maternity services.
在过去十年中，全球公共卫生越来越关注在医疗机构分娩期间对妇女的虐待行为。然而，在卢旺达，关于母亲在分娩期间所经历的不尊重和虐待性护理的研究仍然有限。本研究旨在评估卢旺达基加利一家选定的地区医院中妇女在最近一次分娩期间所经历的不尊重和虐待情况。
我们在卢旺达基加利一家选定的城市地区医院进行了一项横断面研究。我们采用系统随机抽样方法，选取了246名最近在研究地点分娩且已出院但仍在医院内的母亲。我们使用描述性统计方法，并计算了九项不尊重和虐待行为的总和得分，以确定我们感兴趣的结果。随后，我们将结果进行二分法处理。此外，我们使用卡方分析和逻辑回归来确定不尊重和虐待行为的预测因素。
不尊重和虐待行为的发生率为67.48%。在后续问题中，28.86%的参与者报告曾经历过一次不尊重和虐待行为，32.52%的参与者报告曾经历过两到八次。参与者经历不尊重和虐待行为的次数在一到八次之间。最常见的不尊重和虐待行为形式包括：遗弃（n = 77）、不体面护理（n = 76）以及缺乏关于所接受护理的信息（n = 65）。未调整的逻辑分析表明，孕次为3与不尊重和虐待行为显著相关，P值为0.022，粗比值比为3.2（95%置信区间：1.18 - 9.08）。然而，在对其他变量进行调整后，这种关联不再具有统计学意义，调整后的比值比P值为0.061。
我们的研究揭示了分娩期间对妇女不尊重和虐待行为的高发生率。在我们的研究环境中，不尊重和虐待行为仍然是一个重大问题，强调需要通过加强产科服务医护人员的问责机制来采取干预措施减轻这一问题。
