Women's experience of childbirth care in health facilities: a qualitative assessment of respectful maternity care in Afghanistan. 2024

Partamin Manalai, and Nasratullah Ansari, and Hannah Tappis, and Young Mi Kim, and Jelle Stekelenburg, and Jos van Roosmalen, and Sheena Currie
Athena Institute, Vrije Universiteit, Amsterdam, Netherlands. partaminm@gmail.com.

BACKGROUND Respectful maternity care (RMC) remains a key challenge in Afghanistan, despite progress on improving maternal and newborn health during 2001-2021. A qualitative study was conducted in 2018 to provide evidence on the situation of RMC in health facilities in Afghanistan. The results are useful to inform strategies to provide RMC in Afghanistan in spite of the humanitarian crisis due to Taliban's takeover in 2021. METHODS Focus group discussions were conducted with women (4 groups, 43 women) who had used health facilities for giving birth and with providers (4 groups, 21 providers) who worked in these health facilities. Twenty key informant interviews were conducted with health managers and health policy makers. Motivators for, deterrents from using, awareness about and experiences of maternity care in health facilities were explored. RESULTS Women gave birth in facilities for availability of maternity care and skilled providers, while various verbal and physical forms of mistreatment were identified as deterrents from facility use by women, providers and key informants. Low awareness, lack of resources and excessive workload were identified among the reasons for violation of RMC. CONCLUSIONS Violation of RMC is unacceptable. Awareness of women and providers about the rights of women to respectful maternity care, training of providers on the subject, monitoring of care to prevent mistreatment, and conditioning any future technical and financial assistance to commitments to RMC is recommended.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008427 Maternal Health Services Organized services to provide health care to expectant and nursing mothers. Health Services, Maternal,Services, Maternal Health,Health Service, Maternal,Maternal Health Service
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006268 Health Facilities Institutions which provide medical or health-related services. Facilities, Health,Facility, Health,Health Facility
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000288 Administrative Personnel Individuals responsible for the development of policy and supervision of the execution of plans and functional operations. Administrators,Policy Makers,Administrator,Personnel, Administrative,Policy Maker
D000346 Afghanistan Country located north and west of Pakistan, and east of Iran. The capital is Kabul.
D018743 Perinatal Care The care of women and a fetus or newborn given before, during, and after delivery from the 28th week of gestation through the 7th day after delivery. Care, Perinatal

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