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Failure to Deliver: Violations of Women’s Human Rights in Kenyan Health Care Facilities

Failure to Deliver: Violations of Women’s Human Rights in Kenyan Health Care Facilities. FEBRUARY 4,2008 3 RD AFRICA CONFERENCE ON SEXUAL HEALTH RIGHTS. ABUJA NIGERIA Claris Ogangah – FIDA Kenya Elisa Slattery - Center for Reproductive Rights . Overview. Objectives Methodology of Report

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Failure to Deliver: Violations of Women’s Human Rights in Kenyan Health Care Facilities

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  1. Failure to Deliver: Violations of Women’s Human Rights in Kenyan Health Care Facilities FEBRUARY 4,2008 3RD AFRICA CONFERENCE ON SEXUAL HEALTH RIGHTS. ABUJA NIGERIA Claris Ogangah – FIDA Kenya Elisa Slattery - Center for Reproductive Rights

  2. Overview • Objectives • Methodology of Report • Findings • Recommendations

  3. Objectives of report • To document barriers and abuses women in Kenya encounter when seeking/using reproductive health care services in both private and public facilities. • To examine what types of mechanisms for complaints and redress are in place for women who suffer violations or abuse. • To show that what is documented in report constitute serious violations of human rights in addition to having public health implications.

  4. Methodology • Gathered more than 120 women’s experiences through individual interviews, focus groups, and questionnaires, focusing on Nairobi • Interviewed health care providers and administrators, licensing and regulatory bodies, and leaders of medical associations. • Reviewed government guidelines, standards and manuals on RH and media coverage on RH over past 10 years. • Incorporated data from 1998 and 2003 KDHS and 2004 Kenya Service Provision Assessment Survey

  5. Abuse Around Delivery Physical and verbal abuse – • Pinched, slapped, beaten • Called “stupid,” “psycho,” told to “just die” • Cut with scissors to make delivery easier for nurses • Discrimination against younger mothers

  6. Neglect • Having to find labor ward alone • Being left to deliver alone or assisted by another patient • Not receiving care after delivery

  7. Violations around stitching after delivery • Having to wait extended periods of time for stitching after delivery • Being stitched with insufficient or no anesthesia

  8. Barriers to Quality Care • Understaffing • Demoralized health care staff • Contributes to neglect • Can result in trainees treating women - even performing surgeries - without adequate supervision • Lack of supplies/facilities • No gloves, cotton wool, anesthesia • Lack of beds, linens, wrappers for babies • Only 29% of medical facilities had all basic delivery-room infrastructure and equipment

  9. Other Barriers to Quality Care • Unhygienic conditions • Result of understaffing and lack of supplies • KSPAS – hand washing soap missing in 41% of facilities that provide delivery services • Having to deliver on soiled linens and beds • Lack of record-keeping and transparency • KSPAS – only 23% of facilities conduct reviews of maternal and infant deaths or near misses • Some facilities conceal information (PMH)

  10. Economic Discrimination • User fees preventing people from seeking certain kinds of services like reproductive health check-ups • Women being denied delivery services if they cannot pay deposit • Inconsistent and ineffective implementation of exemptions for services • Degrading and lengthy waiver process (where fee is supposed to be waived because of financial need)

  11. Detention in health facilities for inability to pay • This occurs in both public and private facilities • Women who have just delivered being kicked out of bed and forced to sleep on the floor • Having trouble getting food • Being verbally abused

  12. Negative Effects • Affect women’s future decisions about childbearing and seeking reproductive health care • Deciding not to go to health care facility for next delivery • Increased risk of infection for mother and baby, including HIV

  13. Problems Complaining and Seeking Redress • Lack of information about patients’ rights • Not knowing one can complain • Lack of outlined procedures • Difficulties determining where one can complain or how to complain • Slow or no responses to complaints • Difficult getting information from government bodies • No freedom of information act although one has been drafted

  14. Key recommendations • Promote and develop policies and legislation that protect the rights of women seeking RH care and ensure sufficient oversight/regulation in both public and private facilities • Remove all maternal health fees in public hospitals and allocate necessary funds to make quality maternal health care a reality • Ratify Protocol on the Rights of Women in Africa, which explicitly recognizes the right to reproductive health care as key component of women’s fundamental human rights

  15. Thank you!

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