Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya
While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low-resource countries. In Kenya, a large body of research studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspecti...
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doaj-f1509e68e4d446e39aaa3b2634198b562020-11-25T04:04:39ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012020-11-01178218821810.3390/ijerph17218218Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural KenyaAdelaide Lusambili0Stefania Wisofschi1Constance Shumba2Jerim Obure3Kennedy Mulama4Lucy Nyaga5Terrance J. Wade6Marleen Temmerman7Department of Population Health (DPH), Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaDepartment of Population Health (DPH), Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi P.O. Box 30270-00100, KenyaWhile disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low-resource countries. In Kenya, a large body of research studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HCWs) on factors that influence DMC experienced by pregnant women at health care facilities in rural Kisii and Kilifi counties in Kenya. We conducted 24 in-depth interviews with health care workers (HCWs) in these two sites. Data were analyzed deductively and inductively using NVIVO 12. Findings from HCWs reflective narratives identified four areas connected to the delivery of disrespectful care, including poor infrastructure, understaffing, service users’ sociocultural beliefs, and health care workers’ attitudes toward marginalized women. Investments are needed to address health system influences on DMC, including poor health infrastructure and understaffing. Additionally, it is important to reduce cultural barriers through training on HCWs’ interpersonal communication skills. Further, strategies are needed to affect positive behavior changes among HCWs directed at addressing the stigma and discrimination of pregnant women due to socioeconomic standing. To develop evidence-informed strategies to address DMC, a holistic understanding of the factors associated with pregnant women’s poor experiences of facility-based maternity care is needed. This may best be achieved through an intersectional approach to address DMC by identifying systemic, cultural, and socioeconomic inequities, as well as the structural and policy features that contribute and determine peoples’ behaviors and choices.https://www.mdpi.com/1660-4601/17/21/8218disrespectful maternity carerespectful careviolencematernityobstetricrural |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adelaide Lusambili Stefania Wisofschi Constance Shumba Jerim Obure Kennedy Mulama Lucy Nyaga Terrance J. Wade Marleen Temmerman |
spellingShingle |
Adelaide Lusambili Stefania Wisofschi Constance Shumba Jerim Obure Kennedy Mulama Lucy Nyaga Terrance J. Wade Marleen Temmerman Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya International Journal of Environmental Research and Public Health disrespectful maternity care respectful care violence maternity obstetric rural |
author_facet |
Adelaide Lusambili Stefania Wisofschi Constance Shumba Jerim Obure Kennedy Mulama Lucy Nyaga Terrance J. Wade Marleen Temmerman |
author_sort |
Adelaide Lusambili |
title |
Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya |
title_short |
Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya |
title_full |
Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya |
title_fullStr |
Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya |
title_full_unstemmed |
Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya |
title_sort |
health care workers’ perspectives of the influences of disrespectful maternity care in rural kenya |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2020-11-01 |
description |
While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low-resource countries. In Kenya, a large body of research studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HCWs) on factors that influence DMC experienced by pregnant women at health care facilities in rural Kisii and Kilifi counties in Kenya. We conducted 24 in-depth interviews with health care workers (HCWs) in these two sites. Data were analyzed deductively and inductively using NVIVO 12. Findings from HCWs reflective narratives identified four areas connected to the delivery of disrespectful care, including poor infrastructure, understaffing, service users’ sociocultural beliefs, and health care workers’ attitudes toward marginalized women. Investments are needed to address health system influences on DMC, including poor health infrastructure and understaffing. Additionally, it is important to reduce cultural barriers through training on HCWs’ interpersonal communication skills. Further, strategies are needed to affect positive behavior changes among HCWs directed at addressing the stigma and discrimination of pregnant women due to socioeconomic standing. To develop evidence-informed strategies to address DMC, a holistic understanding of the factors associated with pregnant women’s poor experiences of facility-based maternity care is needed. This may best be achieved through an intersectional approach to address DMC by identifying systemic, cultural, and socioeconomic inequities, as well as the structural and policy features that contribute and determine peoples’ behaviors and choices. |
topic |
disrespectful maternity care respectful care violence maternity obstetric rural |
url |
https://www.mdpi.com/1660-4601/17/21/8218 |
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