Disrespectful Maternity Care Experiences Negatively Influence Future Intention to Use Institutional Delivery in Northern Ethiopia

Abstract

Background

Ethiopia has successfully increased antenatal care coverage substantially, but deliveries attended by skilled providers are still low. Disrespectful and abusive maternity care practices are believed to be among the factors deterring institutional delivery services. However, information on the relationship between women’s experience of disrespect and abuse (D&A) and their future intention to give birth at health facilities is lacking in our context. Therefore, the aim of this study was to examine the association between experiencing disrespectful care and future intention of women to utilize health facilities for delivery.

Methods

A cross-sectional study was conducted in Tigray, Ethiopia. Data were collected using a structured questionnaire. Women who had given birth in the health facilities in the twelve months preceding the study were interviewed. D&A was self reported by the women. Bivariable and multivariable logistic regression models were employed to examine the relationship between future intention of women to use institutional delivery services and their past experience of D and A while receiving maternity care services.

Results

A total of 1,031 women who delivered in health facilities in the last 12 months participated in the study. Of which, 156 (15.1%) reported having experienced two or more types of D&A while receiving labour and delivery care services. Experiences of D&A were strongly associated with the  intention to use the health facility in future deliveries. The odds of having no intention to use health facilities for future deliveries was extremely high among women who reported they had experienced D&A (aOR= 59.42; 95% CI: 30.082, 117.359).

Conclusion

Disrespectful and abusive experiences strongly deterred future use of maternal health services. In order to achieve the desired level of institutional delivery coverage in low- and middle-income countries, attention must be given to improve the manner in which services are offered.

Keywords: Intention to deliver at a health facility, Respectful maternity care, Disrespect and abuse, Tigray, Ethiopia

DOI: 10.7176/JHMN/72-01

Publication date:March 31^st 2020