Working Paper Article Version 1 This version is not peer-reviewed

Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya

Version 1 : Received: 16 September 2020 / Approved: 17 September 2020 / Online: 17 September 2020 (11:21:16 CEST)

How to cite: Lusambili, A.; Wisofschi, S.; Shumba, C.; Obure, J.; Mulama, K.; Nyaga, L.; Wade, T.; Temmerman, M. Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya. Preprints 2020, 2020090400 Lusambili, A.; Wisofschi, S.; Shumba, C.; Obure, J.; Mulama, K.; Nyaga, L.; Wade, T.; Temmerman, M. Health Care Workers’ Perspectives of the Influences of Disrespectful Maternity Care in Rural Kenya. Preprints 2020, 2020090400

Abstract

While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low resource countries. In Kenya, a large body of research studies or has studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HWCs) on factors that influence DMC experienced by pregnant women at health care facilities in rural Kisii and Kilifi counties in Kenya. We conducted 24 in-depth interviews with health care workers (HCWs) in these two sites. Data were analyzed deductively and inductively using NVIVO 12. Findings from HCWs reflective narratives identify four areas connected to the delivery of disrespectful care including poor infrastructure, understaffing, service users’ socio–cultural beliefs, and health care workers’ attitudes toward marginalized women. Investments are needed to address health systems influences on DMC including poor health infrastructure and understaffing. Additionally, it is important to reduce cultural barriers through training on HCWs interpersonal communication skills. Further, strategies are needed to affect positive behavior changes among HCWs directed at addressing stigma and discrimination of pregnant women due to socio-economic standing. To develop evidence-informed strategies to address DMC, a holistic understanding of the factors associated with pregnant women’s poor experiences of facility based maternity care is needed. This may best be achieved through an intersectional approach to address DMC by identifying systemic, cultural, and socio-economic inequities as well as the structural and policy features that contribute and determine peoples’ behaviors and choices.

Subject Areas

respectful maternity care; disrepectful maternity care; violence; obsteteric; rural; kenya

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