RESPECTFUL MATERNITY CARE AND ASSOCIATED FACTORS AT KITALE COUNTY REFERRAL HOSPITAL, TRANS NZOIA COUNTY, KENYA

Abstract

Respectful maternity care (RMC) is an avenue that ensures pregnant women preferences, needs and rights are adhered to when seeking maternity services. It remains a global challenge as most pregnant women seeking maternity services don’t receive respectful maternity care. This contributes negatively to maternal and neonatal outcomes. This study aimed at assessing RMC and associated factors at Kitale county referral hospital in Trans Nzoia county. Specifically, it sought to explore perception on RMC among women who have delivered; determine women related factors that influence RMC; assess institutional factors and examine provider factors that influence RMC at Kitale county referral hospital. A cross-sectional study design with mixed method approach was used. Purposive sampling method was used to select the facility while census method was used to arrive at the women and healthcare providers. Data collection tools used were two questionnaires and an interview guide. The postnatal women tool dealt specifically with women who had delivered while the healthcare provider tool addressed healthcare providers (HCP). Postnatal women tool had information on socio-demographic characteristics of women, obstetric features, social support, health system factors and women perspectives on RMC while healthcare provider tool dealt with HCP on RMC. An interview guide was used to explore perceptions among women on RMC. Bivariate analysis was used to recognize variables associated with RMC while multivariate analysis was used to control for confounders. SPSS version 23.0 database was used in this. A p-value of 0.05 was used to determine statistical significance. Inadequate equipment, limited supplies, limited infrastructure, facility management and working environment were institutional factors that influence RMC while Inadequate number of HCP, high workload, motivation and training on RMC were key among HCP. Moreover, marital status, place of residence, employment status, parity, previous birth place, type of delivery and having a complication at birth were significant women related factors that influence RMC. Besides, women felt dignified care and privacy were key challenges as they received care in the unit. The study recommends availability of equipment and adequate supplies in the facility as HCP to continue offering RMC despite the challenges they face. Moreover, women need to be aware of their universal rights, enlightenment on birth positions and pain care. In conclusion, limited supplies and inadequate equipment were the key facility obstacles in RMC care while HCP were faced with inadequate number, high workload and needed trainings on RMC and be motivated. Lastly, women felt that their privacy, dignity and pain relief/comfort in the maternity unit needed to be addressed.