Factors predictive of health care provider mistreatment of mothers during childbirth in a county of Kenya
Tonui, Florence Cherono
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The infant and maternal mortality rates continue to be a concerning factor in Kenya. The challenges of proper quality care, sufficient health care personnel, distance to the health care centers and shortages of supplies at the health centers continue to undermine the dire need for obstetric health care services. Apart from these challenges, expectant mothers look forward to the time their baby is born, unfortunately for some; they will experience mistreatment from the time of pregnancy until childbirth. Even more disturbing is the fact that in some cases, mistreatment has come to be seen as a normalized part of the birthing process. Therefore, this study was conducted to determine the extent of childbirth mistreatment by health care providers and to examine factors predictive of mistreatment by health care professionals, as well as, the effects of mistreatment and its relationship to descriptive factors. Available literature and anecdotal evidence from the Kenyan main newspapers, corroborated by this study, evidently show that mistreatment still exists during childbirth. The study employed observational design using quantitative research methods and a snowball convenience sampling technique of women residing in Kericho County, Kenya, who were eighteen years and older, and had delivered at least one child no matter the outcome of the birth. There were 281 total participants through door-to-door as well as through electronic recruitment methods. The study was guided by empowerment theory, and hypotheses that were tested at the .05 level of significance. Responses were entered into Statistical Package for the Social Sciences (SPSS). Several tests were conducted which included: Chi-Square, independent t-test, one-way ANOVA, nonparametric, and logistic regressions. The data analyses were conducted to identify the significant relationships and correlations between descriptive variables and mistreatment. The study discovered that mistreatment was/is still rampant in Kericho County. Of all the 281 participants, 165 (58.7%) admitted to being mistreated during childbirth across five decades (1970s - 2010s). The participants reported being mistreated physically, subjected to non-dignified care / verbally, non-consented clinical care, abandonment, discrimination based on their unique attributes, non-confidential care, and detained for failure to make payments. The act of mistreatment has attributed to mothers losing their babies and/or their own lives, health complications e.g. excessive bleeding, obstetric fistula, brain dead of a child and other health effects on the child and/or the mother. The study also discovered that the soaring desire to deliver babies at home is ascribed to the fear of mistreatment, and suffering the childbirth related health consequences in a skilled health care facility. The results of the study indicated that the mother's tribe, age, number of children, employment status, educational level, the number of prenatal care visits and the preferred health care center, were all predictors of mistreatment.