Exploring providers’ perspectives on respectful maternity care in a regional hospital in Gauteng

Zwane, Sthembile Promise
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Background Women continue to die from preventable pregnancy-related conditions that can be managed using evidence-based care and delivery in healthcare facilities supervised by skilled birth attendants. However, women are not willing to deliver in maternity healthcare facilities because of the reported widespread disrespect and abuse. One of the proposed interventions has been the roll-out of respectful maternity care (RMC) in all healthcare facilities providing maternity services. While respecting women who seek maternity services has been studied, the focus has been on the perceptions of individual professional groups of healthcare providers such as midwives and nurses, this is despite the fact that maternity care is provided by multidisciplinary not individual professional teams. The purpose of the study was to explore the perspectives of RMC by a multidisciplinary team of healthcare providers working at a specialised mother and child academic regional hospital in Gauteng Province, South Africa. Methodology An explorative, descriptive, and contextual study design within a qualitative paradigm with the adoption of a phenomenological perspective as a measuring strategy, was used. Semi-structured interviews were conducted with 30 purposively selected healthcare providers supervising and rendering maternity care services at Rahima Moosa Mother and Child Hospital. All interviews were digitally recorded, transcribed, and analysed using Tech’s Constant Comparison data analytical approach. Results Seven themes and twelve subthemes emerged. The themes and subthemes fall under two categories, (1) healthcare workers’ perceptions and attitudes on RMC and (2) enabling conditions for the practice of RMC. In terms of perceptions and attitudes, overall healthcare providers had positive attitudes towards RMC perceived it to focus on three key areas: (1) women-centered care, (2) provision of high-quality care, and (3) preservation and promotion of women’s rights. Furthermore, providers perceived the enabling conditions for the practice of RMC to include (1) creating an enabling environment for healthcare providers to practice RMC, (2) in-service training, (3) accountability of healthcare providers for their actions as well as (4) community education and involvement. Conclusion Healthcare providers’ perspective of RMC in this study is in line with global understanding. This study further highlights the importance of creating enabling conditions in order for RMC to be realised.
A dissertation submitted in fulfilment of the requirements for the degree of Master of Science in Medicine (Obstetrics and Gynaecology) to the Faculty of Health Sciences, School of Clinical Medicine, University ofWitwatersrand, Johannesburg, 2022