Patient and provider determinants for receipt of three dimensions of respectful maternity care in Kigoma Region, Tanzania-April-July, 2016

Details

• Alternative Title:
  Reprod Health
• Personal Author:
  Dynes, M. M. ; Twentyman, E. ; Kelly, L. ; Maro, G. ; Msuya, A. A. ; Dominico, S. ; Chaote, P. ; Rusibamayila, R. ; Serbanescu, F.
• Description:
  Background
  
  Lack of respectful maternity care (RMC) is increasingly recognized as a human rights issue and a key deterrent to women seeking facility-based deliveries. Ensuring facility-based RMC is essential for improving maternal and neonatal health, especially in sub-Saharan African countries where mortality and non-skilled delivery care remain high.
  
  Methods
  
  We conducted cross-sectional surveys across 61 facilities in Kigoma Region, Tanzania, from April to July 2016. Measures of RMC were developed using 21-items in a Principal Components Analysis (PCA). We conducted multilevel, mixed effects generalized linear regression analyses on matched data from 249 providers and 935 post-delivery clients. The outcomes of interest included three dimensions of RMC—Friendliness/Comfort/Attention; Information/Consent; and Non-abuse/Kindness—developed from the first three components of PCA. Significance level was set at p < 0.05.
  
  Results
  
  Significant client-level determinants for perceived Friendliness/Comfort/Attention RMC included age (30–39 versus 15–19 years: Coefficient [Coef] 0.63; 40–49 versus 15–19 years: Coef 0.79) and self-reported complications (reported complications versus did not: Coef − 0.41). Significant provider-level determinants included perception of fair pay (Perceives fair pay versus unfair pay: Coef 0.46), cadre (Nurses/midwives versus Clinicians: Coef − 0.46), and number of deliveries in the last month (11–20 versus < 11 deliveries: Coef − 0.35).
  
  Conclusions
  
  These findings illustrate the value of including both client and provider information in the analysis of RMC. Strategies that address provider-level determinants of RMC (such as equitable pay, work environment, access to mentoring platforms) may improve RMC and subsequently address uptake of facility delivery.
  
  
• Subjects:
  Adolescent Adult Age Factors Cross-Sectional Studies Female Humans Income Linear Models Maternal Health Services/standards Middle Aged Pregnancy Pregnancy Complications/epidemiology Principal Component Analysis Research Workload

  More +
• Source:
  Reprod Health. 15.
• Pubmed ID:
  29506559
• Pubmed Central ID:
  PMC5838967
• Document Type:
  Journal Article
• Funding:
  41363/Bloomberg Family Foundation/ ; 41363/Fondation H&B Agerup/
• Place as Subject:
  Tanzania
• Volume:
  15
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ad718bfa2b62f5d06799d174c0e8e4b7b51511fbb6b07ef25f40b7398ede7880
• Download URL:
  https://stacks.cdc.gov/view/cdc/53432/cdc_53432_DS1.pdf
• File Type:
  [PDF - 637.85 KB ]