NDLI: Provider and client perspectives on maternity care in Namibia: results from two cross-sectional studies

Content Provider	Springer Nature : BioMed Central
Author	Wesson, Jennifer Hamunime, Ndapewa Viadro, Claire Carlough, Martha Katjiuanjo, Puumue McQuide, Pamela Kalimugogo, Pearl
Abstract	Background Disrespectful and abusive maternity care is a complex phenomenon. In Namibia, HIV and high maternal mortality ratios make it vital to understand factors affecting maternity care quality. We report on two studies commissioned by Namibia’s Ministry of Health and Social Services. A health worker study examined cultural and structural factors that influence maternity care workers’ attitudes and practices, and a maternal and neonatal mortality study explored community perceptions about maternity care. Methods The health worker study involved medical officers, matrons, and registered or enrolled nurses working in Namibia’s 35 district and referral hospitals. The study included a survey (N = 281) and 19 focus group discussions. The community study conducted 12 focus groups in five southern regions with recently delivered mothers and relatives. Results Most participants in the health worker study were experienced maternity care nurses. One-third (31%) of survey respondents reported witnessing or knowing of client mistreatment at their hospital, about half (49%) agreed that “sometimes you have to yell at a woman in labor,” and a third (30%) agreed that pinching or slapping a laboring woman can make her push harder. Nurses were much more likely to agree with these statements than medical officers. Health workers’ commitment to babies’ welfare and stressful workloads were the two primary reasons cited to justify “harsh” behaviors. Respondents who were dissatisfied with their workload were twice as likely to approve of pinching or slapping. Half of the nurses surveyed (versus 14% of medical officers) reported providing care above or beneath their scope of work. The community focus group study identified 14 negative practices affecting clients’ maternity care experiences, including both systemic and health-worker-related practices. Conclusions Namibia’s public sector hospital maternity units confront health workers and clients with structural and cultural impediments to quality care. Negative interactions between health workers and laboring women were reported as common, despite high health worker commitment to babies’ welfare. Key recommendations include multicomponent interventions that address heavy workloads and other structural factors, educate communities and the media about maternity care and health workers’ roles, incorporate client-centered care into preservice education, and ensure ongoing health worker mentoring and supervision.
Related Links	https://bmcpregnancychildbirth.biomedcentral.com/counter/pdf/10.1186/s12884-018-1999-3.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	14712393
DOI	10.1186/s12884-018-1999-3
Journal	BMC Pregnancy and Childbirth
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2018-09-05
Access Restriction	Open
Subject Keyword	Reproductive Medicine Maternal and Child Health Gynecology Childbirth Institutional delivery Respectful maternity care Disrespect and abuse Quality of care Maternity care workers Nurses Workload
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3.4/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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