TITLE:
Patient and Provider Perspectives of Disrespect and Abuse during Childbirth in Tanzania: A Literature Review
AUTHORS:
Gopika Das, Theresia John Masoi, Stephen M. Kibusi, Arun Chaudhary, Mary Greenwald, Annekathryn Goodman
KEYWORDS:
Disrespect and Abuse, Traumatic Birth, Traumatic Childbirth, Obstetrical Vi-olence Dehumanized Birth, Tanzania
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.9,
September
29,
2021
ABSTRACT: Objective: Disrespectful and abusive (D&A) maternity care is a deterrent to
facility childbirth and can thus contribute to child and maternal mortality.
This study will review existing literature on D&A in Tanzania to better
understand and contextualize the issue. Methods: A comprehensive
literature search was conducted to find relevant publications on D&A during
childbirth in Tanzania. The search was conducted on the National Center for
Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine
at the National Institutes of Health). The inclusion criteria were as follows:
qualitative, quantitative, and ethnographic studies conducted in Tanzania on
obstetrical violence; published in English; focused on prevalence, incidence,
root causes, historical trends, interventions, and policy recommendations for
obstetrical violence in Tanzania. Results: Twenty-one studies were
selected for this literature review. Up to 73.1% of women reported experiencing
at least one form of D&A during labor. Commonly reported D&A events
include non-dignified care, non-confidential care, and physical abuse. Other
forms of D&A, including detention in facilities and asking for unofficial
payments, are also reported. Ninety-six percent of nurses, midwives, and
nursing assistants in Tanzania self-reported engaging in at least one form of
D&A. Lack of training and provider support, long work hours, fear of blame,
and limited infrastructure were reported as factors leading to D&A by
providers. Conclusions: In Tanzania, D&A during childbirth is
prevalent in healthcare systems. The direct relationship between D&A and
poor maternal and fetal health is well-documented. Individual and systemic
factors influence both provider and patient
perspectives of D&A, providing a window into a complex and sensitive
phenomenon. It is important that D&A in Tanzania be viewed holistically,
and that interventions target the multifaceted nature of the issue.