Kasaye Habtamu, Scarf Vanessa, Sheehy Annabel, Baird Kathleen
Collectives of Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Midwifery Department, School of Nursing and Midwifery, Institute of Health Science, Wollega University, Nekemte, Ethiopia.
Glob Health Action. 2025 Dec;18(1):2526890. doi: 10.1080/16549716.2025.2526890. Epub 2025 Jul 8.
Mistreatment of women during maternity care is a widespread global issue, particularly in low- and middle-income countries where health disparities intersect with rigid gender norms, systemic inequality and domestic violence.
This paper aims to explore how health system failures and societal norms against women contribute to the mistreatment of women during maternity care.
A qualitative study was conducted among maternal healthcare providers in the East Wollega Zone, Ethiopia. In-depth interviews with purposively selected participants in Afan Oromo, each lasting 30-60 min, were conducted until data saturation was reached at 20 interviews. The interviews were audio-recorded, transcribed, translated into English, coded using NVivo 12 and analysed through thematic analysis guided by the Socioecological and Quality of Care frameworks.
Health system conditions and constraints, such as under-resourcing and issues related to governance and providers' prejudices shaped by societal norms, were found to drive mistreatment of women during maternity care. These drivers manifest at various levels throughout the healthcare system, including personal, interpersonal, facility-level, health system and societal dimensions. Overcrowding, staff shortages and low pay led to burnout, which eventually resulted in mistreatment of women. The lack of recognition from administrators and professional hierarchies also added to provider frustration, which was sometimes directed at women. Societal issues, like gender-based violence, further influenced these behaviours.
Mistreatment of women during maternity care continues to hinder the delivery of quality care. Addressing gender inequality, boosting healthcare worker motivation and ensuring fair treatment among staff are essential for promoting respectful maternity care.
孕产妇护理期间对妇女的虐待是一个全球性普遍问题，尤其是在低收入和中等收入国家，在这些国家，健康差距与严格的性别规范、系统性不平等和家庭暴力相互交织。
本文旨在探讨卫生系统失灵和针对妇女的社会规范如何导致孕产妇护理期间对妇女的虐待。
在埃塞俄比亚东沃莱加区对孕产妇保健提供者进行了一项定性研究。对以奥罗莫语有目的地挑选的参与者进行深入访谈，每次访谈持续30 - 60分钟，直至进行20次访谈达到数据饱和。访谈进行了录音、转录、翻译成英文，使用NVivo 12进行编码，并在社会生态和护理质量框架的指导下通过主题分析进行分析。
发现卫生系统状况和制约因素，如资源不足以及治理和受社会规范影响的提供者偏见等问题，是导致孕产妇护理期间对妇女虐待的原因。这些驱动因素在整个医疗系统的各个层面都有体现，包括个人、人际、机构层面、卫生系统和社会层面。过度拥挤、人员短缺和低工资导致职业倦怠，最终导致对妇女的虐待。管理人员和专业层级缺乏认可也加剧了提供者的挫败感，这种挫败感有时会针对妇女。诸如基于性别的暴力等社会问题进一步影响了这些行为。
孕产妇护理期间对妇女的虐待继续阻碍高质量护理的提供。解决性别不平等、提高医护人员积极性以及确保工作人员之间的公平待遇对于促进尊重孕产妇护理至关重要。
