REPRODUCTIVE JUSTICE

MEDICALIZATION IN MATERNAL HEALTHCARE

AFRICA

CAMEROON

2018

Moungbakou, I. (2018).  Commodification of care and its effects on maternal health in the Noun division (West Region - Cameroon). doi: 10.1186/s12910-018-0286-1   Accessed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019987/

• In this study aimed at developing knowledge on the impact of the commodification of maternal healthcare on antenatal care and facility-based delivery, it emerged that maternity services have become a real market where providers are almost indifferent to pregnant women who are financially vulnerable. Health professionals in charge of maternal healthcare services deliver attentive care in hospital or at home to privileged women who provide them, through unofficial fees, with additional revenues.

ETHIOPIA

2020

• CONCLUDED: "This systematic review renowned that disrespectful and abusive care of women during childbirth is repeatedly practiced care in Ethiopia, and this finding specifically positions the contributing factors in a broad range and consequences of D and A as a deterrent for utilization of facility-based childbirth at present and subsequent times. To address this alarming problem, therefore, participation in empowering and educating of women on their rights and expectations during childbirth, creating conducive environments for health care providers, strengthening of health systems on respectful maternity care, providing training for pre and in-service care providers on interpersonal and communication skills, implementation of standard-based management and recognition (SBM-R) approach to improve the quality of maternal health, strong legal redresses mechanism in case of complaints, and implementing of policies for standard care of respectful maternity care is utmost importance. In addition, observational, qualitative, and mixed types of studies are required to provide comprehensive evidences on disrespect and abuse during childbirth in Ethiopia"

GUINEA

2017

Balde, M. D., Diallo, B. A., Bangoura, A., Sall, O., Soumah, A. M., Vogel, J. P., & Bohren, M. A. (2017). Perceptions and experiences of the mistreatment of women during childbirth in health facilities in Guinea: a qualitative study with women and service providers. Reproductive Health, 14(1), 3–3. https://doi.org/10.1186/s12978-016-0266-1

• CONCLUDED: "In conclusion, this study shows that mistreatment exists in Guinea and occurs in many forms, including physical and verbal abuse, neglect and abandonment. We recommend that stakeholders in the Ministry of Health, WHO, and hospitals in Guinea start to discuss this important topic and work together to prevent mistreatment from occurring."

KENYA

2019

Ochieng, C. A., & Odhiambo, A. S. (2019). Barriers to formal health care seeking during pregnancy, childbirth and postnatal period: a qualitative study in Siaya County in rural Kenya. BMC Pregnancy and Childbirth, 19(1), 339–339. https://doi.org/10.1186/s12884-019-2485-2    Accessed https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2485-2

• Results:  Multiple factors beyond the commonly reported distance to health facility and lack of transportation and finances explained the low utilization of services. Emergent themes included a lack of understanding of the role of ANC beyond the treatment of regular ailments. Women with no complicated pregnancies therefore missed or went in late for the visits. A missed health visit contributed to future missed visits, not just for ANC but also for facility delivery and postnatal care. The underlying cause of this relationship was a fear of reprimand from the health staff and denial of care. The negative attitude of the health workers explained the pervasive fear expressed by the participants, as well as being on its own a reason for not making the visits. The effect was not just on the woman with the negative experience, but spiraled and affected the decision of other women and their social networks.

2017

• CONCLUDED: "The results described here build on the ever-expanding literature on mistreatment of women during labour and childbirth –outlining drivers from an individual, family, community, facility and policy level. New frameworks to group the manifestations into themes or components makes it increasingly more focused on specific interventions to promote respectful maternity care. The Kenya findings resonate with budding literature – demonstrating that this is indeed a global issue that needs a global solution."

NIGERIA

2016

• CONCLUDED: "Findings from this qualitative study can be used to help facilitate this dialogue in Nigeria by engaging key stakeholders to discuss what can be done to challenge these norms and hold providers accountable for their actions. Jewkes hypothesizes that the construct of the “nursing identity” emphasizes moral superiority and control over the “inferior patient” and lacks a commitment to ethics that precludes mistreating a woman (Jewkes et al., 1998). Until women and their families are able to freely condemn poor quality care in health facilities and healthcare providers are held accountable for their actions, there will be little incentive to foster change. Understanding how and why exerting control over a woman in labor by slapping and shouting at her are acceptable actions requires deeper inquiry into normative attitudes and behaviors on the maternity ward."

SIERRA LEONE

2020

McLean, K. E. (2020). Men’s experiences of pregnancy and childbirth in Sierra Leone: Reexamining definitions of “male partner involvement.” Social Science & Medicine (1982), 265, 113479–113479. https://doi.org/10.1016/j.socscimed.2020.113479

• From Conclusion: While global health scholarship on reproductive health has recently begun to acknowledge men by calling for increased male partner involvement, the focus has been predominantly on men as partners-as women's "semi-significant other”-rather than men as men. The problem with this framing is that it largely ignores men's own experiences and perspectives on pregnancy and childbirth, and, further, erases what men are already doing to provide care in locally constructive ways.

SUB SAHARAN

2020

• CONCLUDED: "In this study disrespect and abuse of women during the process of childbirth at health facilities is high compared to other studies, particularly non confidential care and abandonment is high compared to other studies. This study point out that ministry of health, health care providers, maternal health experts shall due attention to women’s right during the process of childbirth at health facilities. The health care providers also should give women centered care and respect the culture of women during maternity care services.  Therefore, Sub-Saharan Africa countries and their policy planners use this information for evidence-based strategy to lessen disrespect and abuse of woman during the process of childbirth at health facilities. This meta-analysis is an input for international community, stakeholders and policy makers to show where we are and to give woman friendly service."

2019

• CONCLUDED: "Lack of understanding for these professionals and the constraints under which they operate sells midwives and their efforts short, effectively constituting D&A of midwives. Serious consideration of the legacies that have shaped the health system, such as models of care and training, and the prevailing cultural norms within which these are nested, is vital. This will necessitate much wider, interdisciplinary perspectives to find meaningful and respectful ways of consulting with midwives, women and communities to address the challenges they face together." (material omitted) 

TANZANIA

2018

UGANDA

2014

• Conclusions:   This study generates information on perceived roles, expectations, experiences and challenges faced by men who wish to be involved in maternal health issues, particularly during pregnancy and childbirth. There is discord between the policy and practice on male involvement in pregnancy and childbirth. Health system factors that are critical to promoting male involvement in women’s health issues during pregnancy and childbirth need to be addressed.

INTRODUCTION PAGE