Assessment of Factors Associated with Disrespect and Abuse during Institutional Delivery among Postnatal Mothers in the Tamale Metropolis

Abstract

Background: Disrespect or abuse is a mistreatment of women during pregnancy, childbirth or postpartum period. It is one of the contributing factors of low uptake of institutional delivery. In Ghana, there is little information about disrespect or abuse during childbirth in public health facilities. The objective is to identify factors associated with disrespect and abuse during facility-based childbirth in Tamale metropolis. Methods: The study employed a descriptive cross-sectional study design with a mixed methods approach. The study was conducted in the Northern Regional Hospital and the Tamale West Hospital, both in the Tamale Metropolis. The study population comprised women who had given birth in the selected health facilities within northern Ghana. Participants were chosen using a systematic random sampling technique. The total study participants for this study were 424 as the final sample size. Data collection was facilitated using a computerized instrument deployed on tablets.  The data were downloaded from the Google Form into Microsoft Excel, cleaned, coded, imported, and analysed by employing the Statistical Package for the Social Sciences (SPSS) version 24. Results: The result showed that the majority of the respondents (53%) agreed that lack of healthcare provider training in respectful maternity care can lead to disrespect and abuse. Respondents strongly agree (52.0%) that cultures that normalize disrespect and abuse during childbirth contribute to disrespect and abuse. Respondents (56.4%) were aware of any efforts or initiatives in their area to raise awareness and address disrespect and abuse during childbirth. Moreover, respondents (49.0%) agree that lack of nurses and midwives’ adherence to the patient’s charter of Ghana Health Service can lead to disrespect and abuse. Conclusion: The occurrence of disrespect and abuse during facility-based childbirth is determined by an intricate interaction of elements associated with the health system, provider attitudes, training, sociocultural norms, and health regulations. To tackle these concerns, a thorough strategy is needed that encompasses enhancing health systems, training providers, and tackling societal attitudes and practices that contribute to disrespect and abuse.