Health workers’ and hospital administrators’ perspectives on mistreatment of women during facility‑based childbirth: a multicenter qualitative study in Ghana
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
Background: Globally, mistreatment of women during facility-based childbirth continues to impact negatively on
the quality of maternal healthcare provision and utilization. The views of health workers are vital in achieving comprehensive
understanding of mistreatment of women, and to design evidence-based interventions to prevent it. We
explored the perspectives of health workers and hospital administrators on mistreatment of women during childbirth
to identify opportunity for improvement in the quality of maternal care in health facilities.
Methods: A qualitative study comprising in-depth interviews (IDIs) with 24 health workers and hospital administrators
was conducted in two major towns (Koforidua and Nsawam) in the Eastern region of Ghana. The study was part
of a formative mixed-methods project to develop an evidence-based definition, identification criteria and two tools
for measuring mistreatment of women in facilities during childbirth. Data analysis was undertaken based on thematic
content via the inductive analytic framework approach, using Nvivo version 12.6.0.
Result: Health workers and hospital administrators reported mixed feelings regarding the quality of care women
receive. Almost all respondents were aware of mistreatment occurring during childbirth, describing physical and verbal
abuse and denial of preferred birthing positions and companionship. Rationalizations for mistreatment included
limited staff capacity, high workload, perceptions of women’s non-compliance and their attitudes towards staff.
Health workers had mixed responses regarding the acceptability of mistreatment of women, although most argued
against it. Increasing staff strength, number of health facilities, refresher training for health workers and adequate
education of women about pregnancy and childbirth were suggestions to minimize such mistreatment.
Conclusion: Health workers indicated that some women are mistreated during birth in the study sites and provided
various rationalizations for why this occurred. There is urgent need to motivate, retrain or otherwise encourage health
workers to prevent mistreatment of women and promote respectful maternity care. Further research on implementation
of evidence-based interventions could help mitigate mistreatment of women in health facilities.
Description
Research Article