Development and validation of tool to assess respectful maternity care practices among healthcare providers

Respectful maternity care in healthcare facilities during childbirth is a growing concern around the world. It is more than just an important component of care quality; it is also a human right. The aim of this study was to develop and validate a tool to assess respectful maternity care practices among healthcare providers in Nepal.

This is a cross-sectional study as part of an explanatory sequential mixed-method research design. The tool was developed using 9 steps in three phases: item development, scale development, and scale evaluation. Tool is a five-point Likert scale containing 36 items. Each item was rated on a 1-5 scale ranging from 1 (strongly disagree) to 5 (strongly agree). The participants were healthcare providers working in maternity units of various healthcare centers of Madhesh Province. The items were analyzed for validity and reliability with exploratory factor analysis. The data were analyzed via the Statistical Package for Social Science version 22.

The content validity index (CVI = 0.895), kappa index and content validity ratio (CVR) were calculated for each item and they were within an acceptable range. Analysis of internal consistency revealed an acceptable Cronbach's alpha value (0.925) for the 36 item RMCP scale, and seven subscales. The suitability of the data for factor analysis was confirmed by Kaiser-Meyer-Olkin (0.801), and Bartlett's test of sphericity was significant (0.000). Principal component analysis with varimax with Kaiser normalization rotation identified 7 factors with eigenvalues greater than one, accounting for 74.55% of the observed variance.

A new tool for respectful maternity care practices has been developed through a rigorous process of item generation and validity-reliability assessment in addition to confirmatory factor analysis to assess the respectful maternity care practices of healthcare providers in Nepal which is statistically proven to be valid and reliable, with an appropriate range of confirmatory factor analysis results. Assessing the RMC practices of health care providers during facility-based maternity care may be relevant.