Background Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of... Show moreBackground Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors. Methods A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling. Results A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028). Conclusion Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services. Show less
While the inclusion of extreme poor people is a noble and necessary objective, it is challenging. Attempts to include extreme poor people in development interventìons have often been disappointing.... Show moreWhile the inclusion of extreme poor people is a noble and necessary objective, it is challenging. Attempts to include extreme poor people in development interventìons have often been disappointing. This book addresses the challenge of including the poorest people. lt provides deeper understanding of the mechanisms of in- and exclusion of extreme poor people, the structural causes of extreme poverty and the desirability of a univocal definition of extreme poverty. The book contributes to such an understanding through an analysis of extreme poor and marginalised people and their multiple dimensions of wellbeing. Furthermore, this book sheds light on the discourses and practices applied by development agencies in order to draw lessons about how the extreme poor can be sustainably included in development interventions. This is based on original field research - using a partipatory approach - carried out in Bangladesh, Benin, and (rural and urban) Ethiopia. Show less
