Exploring mistreatment of women during childbirth in a peri-urban setting in Kenya: experiences and perceptions of women and healthcare providers

• Published in: Reproductive health Vol. 15; no. 1; p. 209
• Main Authors: Oluoch-Aridi, Jackline, Smith-Oka, Vania, Milan, Ellyn, Dowd, Robert
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.12.2018; BioMed Central; BMC
• Subjects: Adult; Analysis; Attitude of Health Personnel; Care and treatment; Childbirth & labor; Delivery, Obstetric - psychology; Delivery, Obstetric - standards; Developing countries; Emotional abuse; Female; Health aspects; Health facilities; Health Personnel - psychology; Health services; Health Services Accessibility; Healthcare workers experiences; Humans; Kenya; LDCs; Local government; Low income groups; Maternal & child health; Maternal child nursing; Maternal health; Maternal Health Services - standards; Maternal mortality; Medical care discrimination; Medical malpractice; Medical personnel; Midwifery education; Mistreatment; Obstetrics; Parturition - psychology; Peri-urban; Physical Abuse - psychology; Physical Abuse - statistics & numerical data; Physician-patient relations; Pregnancy; Pregnant women; Qualitative Research; Qualitative study; Quality; Quality of Health Care - standards; Reproductive health; Research methodology; Women; Womens health; Young Adult; Kenya; Ghana; Tanzania; Women; Mistreatment; Qualitative study; Peri-urban; Kenya; Healthcare workers experiences; Maternal health
• DOI: 10.1186/s12978-018-0643-z
• ISSN: 1742-4755

In Kenya, indirectly caused maternal deaths form a significant portion of all maternal deaths within the health system. Many of these deaths are avoidable and occur during delivery and labor. Poor quality health service has been a recurring concern among women in Kenya, with women reporting interactions with healthcare workers that are often demeaning and abusive. This paper explores the experiences and perceptions of both female patients and healthcare workers regarding mistreatment during childbirth. This study aims to provide recommendations on how dignified care can be made the norm, specifically focusing on a peri-urban setting in Kenya. The research was accomplished using qualitative research methods with focus group discussions and in depth interviews with women and healthcare workers. The aim was to gain a deeper understanding of the manifestations of mistreatment within the context of a peri-urban setting in Kenya. Female patients reported different forms of mistreatment, such as verbal abuse, physical abuse, neglect, discrimination, abandonment, poor rapport and failure of the health system to uphold professional standards. The healthcare workers described a health system that was weak and fragmented with poor policy support particularly for the new free maternity services policy leading to the mistreatment of women. Newly formed County Governments need to provide resources for a functioning health system to ensure an enabling environment for the provision of high quality maternal health services. This process can include feedback loops with maternity clients to ensure woman-centered services. Policy makers need to strengthen oversight for the implementation of the free maternity services Community health volunteers can be trained to provide this information. Professional associations that govern the standards of quality care for healthcare workers need to address the mistreatment through retraining and norms transformation.