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Patient and provider determinants for receipt of three dimensions of respectful maternity care in Kigoma Region, Tanzania-April-July, 2016
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Mar 05 2018
Source: Reprod Health. 15.
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Alternative Title:Reprod Health
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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.
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Pubmed ID:29506559
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Pubmed Central ID:PMC5838967
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