Abstract:

Background: Globally, women experience of disrespectful care and abuse (D&A) related directly to providers’ actions during labor and delivery. These actions have been directly linked to poor maternal and child health outcomes. Studies examining the effect of a sustained maternal, newborn and child health interventions effects on D&A remains understudied in Tanzania.

Objective: To compare the prevalence and factors associated with D&A among women post facility-based delivery between Misungwi and Kwimba Districts, in Mwanza.

Methods: A community based cross-sectional study was conducted among mothers in puerperium in Misungwi and Kwimba districts. Data analysis was collected using interviewer-administered questionnaire. Analysis was done using SPSS version 25. Continuous variables were summarized using mean with standard deviation and categorical data summarized using frequencies and proportions. Associations were determined using bivariate and multivariate regression models.

Results: A total of 572 mothers in puerperium participated in the study. About 149/572 (26%) reported to have experienced at least one form D&A treatment during their latest delivery. D&A experiences were comparable between Misungwi (28.3% (82/290) and Kwimba (24.8% (70/282) with a slightly higher proportion in the former district (Chi-square = 0.7, df=1, p=0.35). Commonly reported forms of D&A include disrespect and lack of confidentiality (11.4% (65/572), physical abuse (11.4% (65/572), and inappropriate demand for money (5.2% (30/572). Factors that were significantly associated with D&A experience were having more than five children (aOR 2.03, 95%CI 1.27 – 3.25, p=0.00), residing in pre-urban areas (aOR 0.61, 95%CI 0.040-0.99, p=0.05), having no birth companion (aOR 1.99, 95%CI 1.43-3.77, p=0.04) and delivery by cesarean section (aOR 4.12, 95%CI 2.22-7.62, p=0.00).

Conclusion: D&A experiences among delivery mothers were common and comparable between Misungwi and Kwimba districts with about a quarter of women experiencing some forms of abuse during delivery. It’s important to strengthen the advocacy on the ongoing interventions for the purpose of improving the quality of services to the mothers.