Exploring the Role of Hospital Management in the Promotion and Implementation of Respectful Maternity Care in the Sekyere-South District in Ashanti Region

Abstract

Disrespect and Abuse (D&A) sometimes used interchangeably with Obstetric Violence (OV) against birthing women during facility-based delivery, remain a global public health concern due to its adverse effect of discouraging birthing women from accessing facility-based delivery or care. Consequently, this leads to maternal and neonatal mortality and morbidity, especially in lower and middle-income countries (LMIC). Respectful maternity care (RMC) has been acknowledged as the panacea to the elimination of D&A. The hospital management in their governance oversight responsibility is key to the practice of RMC by midwives. Therefore, the role they play in the promotion and implementation of RMC within the facility is crucial to the prevention of D&A. However, there was a scarcity of literature directly on the role of the hospital management in RMC despite evidence of D&A in Ghana. This study explored the role of the hospital management in the promotion and implementation of RMC in the Sekyere South District, Ghana. A shoulder upon which frontline midwives stand to deliver RMC. An exploratory descriptive qualitative design was employed for the study. Seventeen (17) hospital management members were purposively sampled from three (3) secondary level hospitals: Salvation Army hospital Wiamoase, Seventh Day Adventist hospital Wiamoase and Seventh-Day Adventist hospital Agona-Asamang for this study. A face-to-face interview was conducted with the use of a semi-structured interview guide to collect data from the participants. Thematic content analysis was employed to analyse the data that was audio-recorded and transcribed verbatim. Five major themes emerged from the data. The findings established that the hospital management exercised total oversight responsibility over the practice of RMC within the facility. These findings suggest that the nature of leadership determines the delivery of RMC. It is therefore necessary that management take steps to train other frontline staff on RMC to prevent D&A on all fronts of maternal care delivery.