Cheryl A Moyer1, Sarah Rominski2, Emmanuel Kweku Nakua3, Veronica Millicent Dzomeku4, Peter Agyei-Baffour5, Jody R Lori6. 1. University of Michigan Medical School, 1111 Catherine Street, Ann Arbor, MI 48109, USA. Electronic address: camoyer@umich.edu. 2. University of Michigan Medical School, 1111 Catherine Street, Ann Arbor, MI 48109, USA. Electronic address: sarahrom@umich.edu. 3. Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi, Ghana. Electronic address: manyorogh@yahoo.com. 4. Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi, Ghana. Electronic address: vmdzomeku@gmail.com. 5. Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi, Ghana. Electronic address: agyeibaffour@yahoo.co.uk. 6. University of Michigan School of Nursing, 400 North Ingalls Street, Ann Arbor, MI 48109, USA. Electronic address: jrlori@umich.edu.
Abstract
OBJECTIVE: to determine what midwifery students throughout Ghana were witnessing, perceiving, and learning with regard to respectful care during labour and childbirth. DESIGN: cross-sectional survey. SETTING: public midwifery schools in all 10 regions of Ghana. PARTICIPANTS: all graduating midwifery students in Ghana. MEASUREMENTS: 929 final-year students at 15 public midwifery schools in Ghana were asked to complete a self-administered computerised survey addressing a range of topics, including experiences during training. All data were collected anonymously and analyzed using Stata 13.0. FINDINGS: 853 students completed the questionnaire (91.8% response rate): 72.0% said maltreatment was a problem in Ghana and 77.4% said women are treated more respectfully in private than public facilities. Students described providers: telling women to stop making noise (78.5%), shouting at women (68.8%), scolding women if they didn't bring birth supplies (54.5%), treating educated/wealthy women better than less educated / poor women (41.5%/38.9%), detaining women who couldn't pay (37.9%), and speaking disrespectfully to women (34%). Only 4% of students reported not witnessing any disrespectful treatment. Students reported providers being overworked (76.5%), stressed (74.2%), and working without adequate resources (64.1%). Where students performed their clinical training (teaching hospital, district hospital, public health clinic, private facility) had no effect on perception of maltreatment as a problem. However, students who trained in district hospitals witnessed more types of disrespectful care than those who did not train in district hospitals (p=0.01). CONCLUSIONS AND IMPLICATIONS: a majority of midwifery students throughout Ghana witness disrespectful care during their training. Implications include the need for provider curricula that address psychosocial elements of care, as well as the need to improve monitoring, accountability, and consequences for maltreatment within facilities without creating a culture of blame.
OBJECTIVE: to determine what midwifery students throughout Ghana were witnessing, perceiving, and learning with regard to respectful care during labour and childbirth. DESIGN: cross-sectional survey. SETTING: public midwifery schools in all 10 regions of Ghana. PARTICIPANTS: all graduating midwifery students in Ghana. MEASUREMENTS: 929 final-year students at 15 public midwifery schools in Ghana were asked to complete a self-administered computerised survey addressing a range of topics, including experiences during training. All data were collected anonymously and analyzed using Stata 13.0. FINDINGS: 853 students completed the questionnaire (91.8% response rate): 72.0% said maltreatment was a problem in Ghana and 77.4% said women are treated more respectfully in private than public facilities. Students described providers: telling women to stop making noise (78.5%), shouting at women (68.8%), scolding women if they didn't bring birth supplies (54.5%), treating educated/wealthy women better than less educated / poor women (41.5%/38.9%), detaining women who couldn't pay (37.9%), and speaking disrespectfully to women (34%). Only 4% of students reported not witnessing any disrespectful treatment. Students reported providers being overworked (76.5%), stressed (74.2%), and working without adequate resources (64.1%). Where students performed their clinical training (teaching hospital, district hospital, public health clinic, private facility) had no effect on perception of maltreatment as a problem. However, students who trained in district hospitals witnessed more types of disrespectful care than those who did not train in district hospitals (p=0.01). CONCLUSIONS AND IMPLICATIONS: a majority of midwifery students throughout Ghana witness disrespectful care during their training. Implications include the need for provider curricula that address psychosocial elements of care, as well as the need to improve monitoring, accountability, and consequences for maltreatment within facilities without creating a culture of blame.
Authors: James Avoka Asamani; Ninon P Amertil; Hamza Ismaila; Akugri Abande Francis; Margaret M Chebere; Juliet Nabyonga-Orem Journal: Hum Resour Health Date: 2019-05-22
Authors: Rena Bakker; Ephrem D Sheferaw; Tegbar Yigzaw; Jelle Stekelenburg; Marlou L A de Kroon Journal: Int J Environ Res Public Health Date: 2020-04-14 Impact factor: 3.390