1 / 18

Measuring Disrespect and Abuse during Childbirth in the Western Highlands of Guatemala

Measuring Disrespect and Abuse during Childbirth in the Western Highlands of Guatemala. Emily Peca, MA, MPH GWU/ USAID|TRAction Project Respectful Maternity Care Seminar June 24, 2014. Overview of Presentation. Context of Guatemala Opportunity to explore D&A within an existing effort

hans
Download Presentation

Measuring Disrespect and Abuse during Childbirth in the Western Highlands of Guatemala

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Measuring Disrespect and Abuse during Childbirth in the Western Highlands of Guatemala Emily Peca, MA, MPH GWU/USAID|TRAction Project Respectful Maternity Care Seminar June 24, 2014

  2. Overview of Presentation • Context of Guatemala • Opportunity to explore D&A within an existing effort • Data source • Data collection • Preliminary results • Contribution

  3. Guatemala: Country of Contrasts Disparities in outcomes: by ethnicity, geography, income

  4. The Opportunity TRAction Guatemala’s technical cooperation approach focused on strengthening the network of MNCH & nutrition service delivery in Ixil Health Area Data was collected on health seeking behavior and perceptions related to maternal child health and nutrition services Opportunity: to describe and quantify women’s experiences and perceptions of disrespect and abuse related to facility deliveries

  5. Study Site Ixil is comprised of 3 municipalities in the Department of El Quiche Total Pop. Ixil ~160,000 Majority of the population lives in communities of 500 people or less

  6. Data Source • Qualitative & quantitative data is from 15 rural to remote communities from all three municipalities of Ixil (total pop 7,757) • Communities are categorized as close, intermediate or far to nearest delivery facility. (1 public facility in each municipality) • Partners COTONEB; University of San Carlos

  7. Focus Group Discussions • Comadronas- traditional birth attendants • Women (home birth)- within last five years • Women (facility-birth)- within the last five years

  8. In-depth Interviews • Community leaders: religious leaders, leaders of dev’t committees • Community health workers: head mini-health posts in each of the 15 communities • Women (facility-birth)- within the last five years

  9. Domains Domains Consistent across all FGDs & IDIs • Reasons for delivering in a facility/home • Disrespect and abuse in facilities (experiences/perceptions) • Recommendations for improving facility-based services All data was collected by bilingual (Spanish & Ixil) women from the three municipalities of Ixil

  10. Preliminary Results: Qualitative Data • Quotes from women who gave birth in a facility: • “I was not attended quickly and when my baby was about to come out they pushed me without saying why, this made me feel bad.” • “They gave me cold food and when they drew my blood they never told me why.” • “The providers were not at my side when my baby was born …” • I needed help and the nurse didn’t want to help me. When I asked her help she just said levantate! (get up!), but I couldn’t.” • “They are fromthesamegroup as us (Ixil) butthey do notspeaktous in Ixil and theyscoldus…” Comadrona (TBA)

  11. Preliminary Results: Survey Data Vacant: 148; absent: 87; refused : 11 • 94% self-identified as indigenous; 6% non-indigenous • 19% gave birth to their last child in a facility; majority give birth with comadronas (TBAs)

  12. Survey Data • Questions for measuring disrespect & abuse and respect promoting practices were based on: • Disrespectful & Abusive Maternity Care Framework • Disrespect and abuse studies in East Africa • Formative research in Ixil • Guatemala’s guidelines/norms for culturally appropriate care (Disrespect/Abuse) Bribe Neglect Non-consent Neg. gestures/comment (Respect Promoting) Language Birth Companion Chose Position Preferred clothing

  13. D&A/RMC Questions • Survey included two sets of similar disrespect and abuse questions for women who had a home birth & women who had a facility birth • Facility birth cohort: asked about their own experiences • Home birth cohort: asked about perceptions/beliefs about facility births • This allows for comparison between self-reported experiences and beliefs/perceptions

  14. D&A: Facility Cohort “Global” disrespect and abuse question (facility cohort) indicates 7% prevalence

  15. Results: comparison of experiences vs. perceptions

  16. Contribution • Testing the construct of D&A in a Latin America context (rural, hard-to-reach) • What components of the D&A construct are relevant; missing in context of rural Guatemala • What are the contributors to and consequences of experiencing and perceiving D&A in this context? • Consider relationship between D&A and ‘respect-promoting’ practices • Contribute to measurement lessons: training local data collectors, adapting tool in a local language; data collection in remote areas; measurement as an intervention

  17. Acknowledgments • TRAction Guatemala team based at the URC office in Guatemala, Hernán Delgado (PI) • Implementing partner COTONEB & CHWs • Field supervisors Miguel Brito and Elena Gómez • Data collection teams from Ixil • The families from the 15 communities who shared their time and experiences with us.

More Related