Respectful maternity care and associated factors at Kawempe National Referral Hospital: Mothers’ perspectives.
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Background. Despite the increasing number of facility-based deliveries and expertise worldwide, the decline in the global maternal mortality is slower than expected with vast inequalities between countries and within the same country. Lack of Respectful Maternity Care (RMC) is increasingly scrutinized as a possible explanation of this paradox. For this reason, WHO recommended countries to measure the prevalence of RMC in their institutions, as an essential determinant of quality of care. However, very few studies on prevalence of RMC have been carried out in LMICs, including Uganda. Therefore, the purpose of this study was to assess the level of RMC and its associated factors at Kawempe National Referral Hospital (KNRH), the busiest maternity facility in Uganda. Specific study objectives: (1) To measure the prevalence of RMC at KNRH (2) To identify factors associated with RMC at KNRH Methods. This was a facility-based cross-sectional study conducted on 406 mothers who had delivered at KNRH, selected by a systematic sampling technique. A pretested validated questionnaire was utilized to collect socio-demographic, obstetric and medical characteristics of the participants were collected. An eighteen-items five-point Likert scale questionnaire was used to measure RMC as adapted from Sheferaw’s questionnaire; a tool validated in other LMICs. The tool had subscales for friendly care, abuse-free care, timely care, and discrimination-free care. According to previous literature, lack of RMC for any item categorizes the patient as ‘not receiving RMC’. Results. The study was conducted from 16/05/2022 to 21/06/2022. Only 1 participant out of 406 received RMC, making the prevalence of RMC at KNRH to be 0.25%. Abusive-free care and discrimination-free care were the types of RMC relatively more perceived by the participants (66.9% and 63.4% respectively), whereas friendly care, and especially timely care were reported much more deficient (49.9% and 21.6% respectively). Conclusion. There is lack of RMC at KNRH. Recommendations. There is need for all stakeholders to address the root causes of lack of RMC in order to improve quality of care, and neonatal/maternal outcomes. It also prompts to assess the level of RMC in other institutions in the country. If this gap in RMC is addressed, it could open a new path to steadily improve neonatal/maternal outcomes in Uganda.