Table 1
Tackling disrespect and abuse: seven rights of childbearing women
| Category of disrespect and abuse in RMC | Corresponding right |
|---|---|
| Non-consented care | Right to information, informed consent and refusal, and respect for choices and preferences, including companionship during maternity care |
| Non-confidential care | Confidentiality, privacy |
| Non-dignified care (including verbal abuse) | Dignity, respect |
| Discrimination based on specific attributes | Equality, freedom from discrimination, equitable care |
| Abandonment or denial of care | Right to timely healthcare and to highest attainable level of health |
| Detention in facilities | Liberty, autonomy, self-determination, and freedom from coercion |
[i] Notes. Adapted from White Ribbon Alliance Training Manual, 2011
Table 2
Breakdown of study respondents
| Category of respondent | Number |
|---|---|
| Child bearing women (4 FGDs) each with 8 Respondents | 32 |
| Health workers/midwives (IDI) | 5 |
| PHFs In-Charges (IDI) | 4 |
| Childbearing mother (IDI) | 5 |
| DHTs | 1 |
| Total | 47 |
Table 3
Experiences and perception of RMC among childbearing women in Busia
| Theme | Sub themes | Voices |
|---|---|---|
| Lived experiences | Extortion | • Asking for money • Health workers responding late. • Health workers Absenteeism |
| Non-dignified care | • Abusive and embarrassing words • Harshness (slapping and rudeness) • Physical and psychological abuse | |
| Neglect and abandonment | • Pushing without midwife’s attention • Time of reaching at facility | |
| Discrimination | • Appearance • Birth items/preparedness • Tribal differences • HIV Status • Birth Complications | |
| Privacy and confidentiality | • Structural challenges | |
| Non-consented care | • Clients do not know their rights | |
| Detention in care | • Mother detained for failure of payment in PHFs |
Table 4
Community attitude and values regarding RMC in Busia district
| Theme | Sub-theme | Voices |
|---|---|---|
| Perception | Attitude | • Traditional Birth Attendants • Community maternal status • Personal hygiene |
| Community | Cultural beliefs and practices | • Women never fall ill. • Childbirth not men’s business • Community liaison • Spiritual consideration • Placenta handling • Use of traditional herbs |
Table 5
Facility system contributors to RMC in Busia district
| Theme | Sub-theme | Voices |
|---|---|---|
| Structural | Transport Challenges | • Long distances to PHFs for some women • Bad road terrain • Cost of transport |
| Working Space | • Inadequate space at some health facilities • Privacy and confidentiality | |
| Power reliability | • No hydro power in most facilities • Spoilt batteries for solar | |
| Staff competency | Professionalism | • Use of abusive and harsh language. • Complaint's mechanism |
| Customer care | • Preference of health worker, • Discrimination • Workload • Male involvement | |
| Leadership | Role of local leaders | • Meetings with staff • Health Unit Management Committee |
Table 6
Health systems contributors to RMC
| Theme | Sub themes | Voices |
|---|---|---|
| Drivers of disrespect and abuse | Individual factors | • Lack of awareness about RMC • Cooperation between mothers and midwives • Workload and burnouts |
| Medical supplies and sundries | • Inadequate medical supplies • Inadequate Public Health Care funds | |
| Infrastructural | • Inadequate working space | |
| Attitude | • Community expectations • Emotional breakdown • Upbringing • Character | |
| Training | • Methods of training for health workers • Refresher courses • Upgrading | |
| Leadership | • Support supervision • Penalties for abuse and disrespect of mothers | |
| Communication | • Language barriers • Communication skills | |
| Male involvement | • Failure to accompany wives. • Not knowing facts of pregnancies | |
| Future recommendations | Role of stakeholders | • Infrastructure • Stress management • Time management • Medical supplies • Clients’ charter |