Respectful maternity care: Healthcare workers' perspectives-a cross-sectional study

Respectful maternity care (RMC) is a fundamental right of all pregnant women during childbirth journey. Its implementation depends on the healthcare workers' (HCW) knowledge of RMC and their attitudes toward its practice. This study assessed awareness, knowledge, and factors affecting the practice of RMC during childbirth among HCWs in Ibadan, Nigeria.

This was a descriptive cross-sectional study conducted among 130 HCWs across the three levels of health care using a self-administered questionnaire to assess their awareness, knowledge and factors affecting RMC practice across five domains: job fairness, supervision and promotion, health system, work environment, and working relationships. Data were analyzed with SPSS version 27.0 using descriptive statistics and inferential analysis with the level of statistical significance set at P < 0.05.

The mean age of HCWs was 38.1 years, with the majority (74.6%) being female. Most (41.5%) worked in tertiary health facilities and 48.5% were nurses. Awareness of RMC during childbirth was high (80%), but only 43.3% had adequate knowledge. Across the five domains, profession and place of work were significant predictors of good practice of RMC. In the job fairness domain, doctors (adjusted odds ratio [aOR] = 0.031; 95% confidence interval [CI]: 0.004-0.236) and nurses (aOR = 0.190; 95% CI: 0.053-0.677) had lower odds of good practice compared with community health extension workers (CHEWs) and community health officers (CHOs). HCWs who were aware of RMC had higher odds of good practice compared with HCWs who are not aware of RMC (aOR = 4.297; 95% CI: 1.135-16.260). HCWs in secondary facilities had reduced odds of good practice in supervision and promotion (aOR = 0.165; 95% CI: 0.046-0.586), healthcare system (aOR = 0.186; 95% CI: 0.056-0.619), and the work-environment domain (aOR = 0.190; 95% CI: 0.054-0.671) compared with those in primary facilities. In the working relationships domain, doctors had lower odds of good practice (aOR = 0.148; 95% CI: 0.024-0.920) compared to CHEW/CHOs.

Though the awareness of RMC among HCWs was high, adequate knowledge was limited. Targeted interventions such as workshops, seminars, and training programs are recommended to improve the knowledge and practice of RMC among HCWs working in maternity units.