DISRESPECT AND ABUSE TOWARDS MOTHERS DURING ANTENATAL AND DELIVERY CARE IN ONA-ARA LOCAL GOVERNMENT AREA, OYO STATE

Abstract

Disrespect and Abuse (DA) during pregnancy and childbirth by the health workers may constitute a barrier to the utilisation of skilled care. It has been reported that health workers show disrespect and abusive attitudes toward mothers during antenatal care and childbirth. Little attention has been paid to documenting DA to mothers by health workers in Nigeria. This study was designed to document the forms of DA and associated factors during pregnancy and delivery in maternity centres in Ona-Ara Local Government Area (LGA), Oyo state. A descriptive cross-sectional study involving a three-stage sampling technique was used to select participants. Three wards were randomly selected from Ona-Ara LGA and two (comprehensive) health centers were purposively selected from each ward. Overall, 521 consenting mothers were selected to participate in the study. A semi- structured, self-administered questionnaire was used to collect data on socio-demographic characteristics, obstetric history and mothers' experience of DA during pregnancy and delivery. Participants' experience of DA was rated on a six-point scale with scores ≤3 indicating bad experience and > 3 as good experience. Six focus group discussions were conducted to further assess the DA experience of mothers. Data were analysed using descriptive statistics, Chi square test and logistic regression at p =.0.05. Thematic method was used to analyse the qualitative data. Age of the respondents was 29.2 ±5.5 years. Majority (91.6%)were married and 59.5% had secondary education. About 38% and 30% of the respondents stated that they experienced DA during antenatal care and childbirth respectively. The highest reported form of abuse during pregnancy was verbal (33.7%) while during delivery it was physical (36.5%). About 15% and 21 % of the participants experienced delay in care during pregnancy and delivery respectively. The proportion of mothers who had been previously neglected by the health workers was 15% and 9% during pregnancy and delivery respectively. The respondents who had their previous delivery in a public hospital experienced more abuse (22.9%) than those who utilised private health facilities (18.8%). Overall, 21. 1 % of the respondents reported that they had bad experience while 78. 9% had good experience during pregnancy and delivery.The proportion of mothers aged>39 years (38.5%) and those with informal marriage (62.5%) who had experienced DA were significantly higher compared with those aged ≤39 years (20.2%) and those with formal marriages (21.2%). Older mothers were almost three times more likely (OR= 2.5. 95% CI= 1.1-5.6) to experience DA than younger mothers. Focus group discussion revealed that health workers especially in most public health facilities verbally abuse mothers, delay care deliberately and are disrespectful in their attitude. Disrespectful and abusive antenatal and delivery care were stated as major barriers to accessing care in health facilities. Mothers experienced disrespect and abuse particularly during antenatal at health facilities in Ona Ara Local Government Area. There is need for interventions that promote dignified maternal care to enhance maternal health and care in a bid to achieve Milleniurn Development Goal 4 and 5.