Understanding mistreatment during institutional delivery
Mistreatment of women during facility childbirth is increasingly seen as one of the leading reasons behind the low utilisation of maternal and newborn health services in settings with poor maternal and newborn health outcomes, such as Gombe state. We investigated the quality of care relating to the prevalence and manifestations of mistreatment during institutional birth, finding that mistreatment was reported in two-thirds of all institutional deliveries, with reported prevalence varying across the dimensions of care. Qualitative findings highlighted different forms of mistreatment that might take place during institutional births.
The relative value (utility) associated with a range of childbirth care experience attributes
Widespread mistreatment has been reported but there is a limited understanding of the aspects that matter most to women. We interviewed rural Nigerian women to examine how specific attributes of a hypothetical facility birth experience of care influenced their stated preference for hypothetical place of delivery. We found that poor facility culture, including an unclean birth environment with no privacy, and unclear user fees, negatively impacted choices for facility-based childbirth.
The validity of measures of respectful maternity care derived from exit interviews
Valid methods for assessing respectful maternity care are essential but validation research is sparse, reporting mixed results. We investigated the validity of eight positive and sixteen negative maternity care experience measures derived from exit interviews. We found that maternity care experiences self-reported in exit interviews by women were consistent with the observation of childbirth for all eight positive maternity care experience indicators and six of the sixteen negative maternity care experience indicators investigated.
The validity of telephone interviews to capture data on childbirth care experiences
Health facility staff and managers need frequent and timely data on the experience of childbirth care. Telephone follow-up interviews may be a low-cost option. We investigated the validity of eight indicators of positive maternity care experience and 18 indicators of negative maternity care experience derived via telephone interviews. We found that the telephone interviews conducted 14 months after childbirth did not yield results consistent with exit interviews conducted at the time of discharge.
Women’s perceptions of telephone interviews about their childbirth care experiences
The high coverage of mobile phones in low-and middle-income countries has made telephone interviews a promising alternative or supplement to face-to-face interviews. But there is limited evidence on women’s perceptions and acceptability of telephone interviews about their experiences with facility childbirth care in such settings. We investigated women’s perceptions of phone interviews about their experiences with facility childbirth care, finding that most women had positive views about the phone interviews.
Feasibility and acceptability of primary healthcare provider-led phone follow-up with recent mothers
An established system of integrating the experience of care measures within routine data capture exercises in health facilities is needed to improve women’s experience of childbirth care. We investigated the feasibility and acceptability of primary healthcare provider-led phone follow-up with recently delivered women about their maternity care experiences, finding that it was feasible and acceptable.