Lessons learned through respectful maternity care training and its implementation in Ethiopia: an interventional...

Area of Science:

• Maternal Health
• Healthcare Quality Improvement
• Health Systems Research

Background:

• Respectful maternity care (RMC) is crucial for improving maternal health and eliminating mistreatment during childbirth.
• Evidence on RMC interventions and implementation challenges, particularly in low-resource settings, remains limited.
• This study explores service providers' perspectives on RMC training and implementation experiences.

Purpose of the Study:

• To assess the impact of RMC training on healthcare providers' perceptions and attitudes.
• To identify challenges faced by providers during RMC implementation.
• To understand the role of systemic factors in RMC provision.

Main Methods:

• A mixed-methods study involving pre- and post-intervention surveys and focus group discussions.
• Quantitative data analyzed using McNemar's test to compare perceptions before and after training.
• Qualitative data analyzed using hybrid thematic analysis, with integrated quantitative and qualitative approaches.

Main Results:

• Mistreatment during childbirth, including lack of privacy and physical force, was frequently reported.
• A significant percentage of providers admitted to mistreating women.
• RMC training positively influenced awareness and attitudes but did not address provider rights.
• Structural and systemic issues were identified as major implementation barriers.

Conclusions:

• RMC training alone is insufficient to ensure respectful care.
• Addressing RMC requires a health systems strengthening approach.
• Provider rights and systemic bottlenecks are critical factors for successful RMC implementation.