TY - JOUR
T1 - What makes or mars the facility-based childbirth experience
T2 - Thematic analysis of women's childbirth experiences in western Kenya Prof. Suellen Miller
AU - Afulani, Patience A.
AU - Kirumbi, Leah
AU - Lyndon, Audrey
N1 - Funding Information:
This work was supported by the University of California, San Francisco, Preterm Birth Initiative (PTBi) transdisciplinary post-doctoral fellowship, which is funded by the Bill and Melinda Gates Foundation [OPP1107312]; and Marc and Lynne Benioff. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/12/29
Y1 - 2017/12/29
N2 - Background: Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Methods: Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. Results: The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. Conclusions: This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.
AB - Background: Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Methods: Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. Results: The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. Conclusions: This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.
KW - Childbirth
KW - Experience
KW - Facility delivery
KW - Kenya
KW - Person-centered care
KW - Quality of care
KW - Sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85039697650&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039697650&partnerID=8YFLogxK
U2 - 10.1186/s12978-017-0446-7
DO - 10.1186/s12978-017-0446-7
M3 - Article
C2 - 29284490
AN - SCOPUS:85039697650
VL - 14
JO - Reproductive Health
JF - Reproductive Health
SN - 1742-4755
IS - 1
M1 - 180
ER -