The Effect of a Facility Level Intervention on Disrespect and Abuse during Childbirth: A Controlled Before and After Comparison of Two District Hospital in Abuja, Nigeria

Abstract

Disrespect and abuse of women by health care workers during pregnancy and childbirth is very common especially in developing countries like Nigeria. This is a deterrent to the utilization of available maternal health-care facilities with resultant high maternal morbidity and mortality. Hence there is a need for interventional strategies to reduce the prevalence. This study examines the effectiveness of an educational intervention on the prevalence of disrespect and abuse in two district hospitals in Nigeria. It employed a quasi-experimental design as a control before and after with a comparison to measure the effect of a single intervention on the prevalence of disrespect and abuse experienced by women during childbirth, using two health facilities. A total of three hundred and seventy four (374) women experiencing childbirth, one hundred and eighty seven from each health facility were randomly selected as research participants for a baseline study while the same total number of women were selected after a 3 days training on respectful maternity care targeted at health workers in only one of the hospitals. The overall prevalence of disrespect and abuse among the women at baseline was 92.33%. The results from the logistic regression analysis conducted at post intervention and the z-score comparison of proportion test indicates a significant reduction in the overall prevalence of disrespect and abuse at the intervention site, from 88.2% to 46% with no significant change in the overall prevalence of disrespect and abuse at the control site. It was concluded that there is a significant relationship between educational intervention and prevalence of disrespect and abuse hence recommendations were made for relevant stakeholders to implement strategies that will improve respectful maternity care.