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Exploring Respectful Maternity Care and its determinants: a mixed methods cross-sectional study from a rural area in
Chullithala Athira1, Anindo Majumdar2, Roshan F Sutar3
1Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India. athirachullithala@gmail.com.
Introduction:
This study investigates Respectful Maternity Care (RMC) and its determinants in a rural area of Central India. RMC, which is crucial for reducing maternal mortality, emphasizes dignity, privacy, and autonomy during childbirth. The study aligns with the Sustainable Development Goals (SDG) to improve maternal health outcomes.
Methodology:
A mixed methods study with a convergent parallel design was conducted in the Obedullaganj block of Raisen district in Madhya Pradesh. Participants were mothers who had recently given birth in healthcare facilities of the district. Data measuring Respectful Maternity care was collected using the Person-Centered Maternity Care (PCMC) Scale and in-depth interviews. Descriptive data is presented in frequency tables. Quantitative data were analyzed using logistic regression and qualitative data through thematic analysis.
Results:
The mean PCMC score was 48.6, with 26.3% of women experiencing good Respectful Maternity Care. Significant determinants of poor RMC included delivery in government health facilities (OR:4.58, 95% CI: 1.79 - 11.66), fewer than four antenatal care visits (OR: 2.5, 95% CI: 1.47 - 4.26), vaginal delivery (OR: 5.59, 95% CI: 3.01 - 10.38), and normal birth weight babies (OR: 2.82, 95% CI: 1.44 - 5.52). Qualitative analysis revealed themes around perceived knowledge of Respectful Maternity Care, barriers to delivering respectful care, and health system factors related to the provision of maternity care.
Conclusion:
Respectful maternity care is vital for maternal and child health. The findings highlight that health system constraints such as human resources and their sensitization and training in RMC, among other logistics, must be addressed systematically to ensure respectful maternity care for mothers. The study also revealed that patient-related factors such as social status, economic worth, cultural barriers, illiteracy, lack of autonomy, and gender bias are also predictors of respectful care for mothers. The study's findings emphasize the need for policy and practice changes to ensure respectful maternity care, particularly in rural healthcare settings in India.
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