Mistreatment of Women During Facility-based Childbirth in Dandora, Kenya: A Mixed-methods Study of the Knowledge and Perceptions of Healthcare Providers

Location: Dandora, Kenya

Alumni: Ellyn Milan

Faculty: Vania Smith Oka

Disrespect and abuse during facility-based childbirth are major barriers to accessing quality delivery services for many women. While the actions of healthcare workers have been described, the voices of the healthcare workers are largely missing from the literature regarding the dynamics of disrespectful care in Kenya. The objective of this study was to construct an understanding of the way mistreatment of women during childbirth is perceived, understood, and experienced by healthcare providers in maternity wards that serve the women of Dandora, an informal urban settlement in Nairobi. Both quantitative and qualitative methods were used during in-depth interviews with doctors and midwives currently employed in both public and private maternity wards to analyze the cultural domain of mistreatment. Ethical clearance was obtained from the University of Notre Dame Institutional Review Board and the National Commission for Science, Technology, and Innovation. A total of 37 healthcare workers participated in the studied. Results from the study suggest that healthcare workers not only have knowledge and experiences of mistreatment of women occurring during the intrapartum process, but regard various forms to be acceptable and normalized under certain circumstances. This study is significant because unlike previous studies, it focused on mistreatment as a cultural domain of knowledge held and shared by healthcare workers, and examined how various types of disrespect and abuse are contextualized within that domain. Moving forward, any approach to confront and prevent the occurrence of mistreatment must consider these important social contexts, and further research is needed on how it may be measured and prevented.

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