‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania
Background Rights-based Respectful Maternity Care (RMC) is crucial for quality of care and improved birth outcomes, yet RMC measurements are rarely included in facility improvement initiatives. We aimed to (i) co-create a routine RMC measurement tool (RMC-T) for congested maternity units in Dar es S...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2024.2403972 |
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| _version_ | 1832096662034579456 |
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| author | Brenda Sequeira D’mello Natasha Housseine Hussein Lesio Kidanto Nanna Maaløe Jos van Roosmalen Dan Wolf Meyrowitsch Thomas van den Akker Zainab Muniro Evance Polin Nuswe Ambokile Charles Festo Jane Brandt Sørensen David Sando |
| author_facet | Brenda Sequeira D’mello Natasha Housseine Hussein Lesio Kidanto Nanna Maaløe Jos van Roosmalen Dan Wolf Meyrowitsch Thomas van den Akker Zainab Muniro Evance Polin Nuswe Ambokile Charles Festo Jane Brandt Sørensen David Sando |
| author_sort | Brenda Sequeira D’mello |
| collection | DOAJ |
| description | Background Rights-based Respectful Maternity Care (RMC) is crucial for quality of care and improved birth outcomes, yet RMC measurements are rarely included in facility improvement initiatives. We aimed to (i) co-create a routine RMC measurement tool (RMC-T) for congested maternity units in Dar es Salaam, Tanzania, and (ii) assess the RMC-T’s acceptability among women and healthcare stakeholders. Method We employed a participatory approach utilizing multiple mixed methods. This included a scoping review, stakeholder engagement involving postnatal women, healthcare providers, health leadership, and global researchers through interviews, focus groups, and two surveys involving 201 and 838 postnatal women. Cronbach’s alpha and factor analysis were conducted for validation using Stata 15. Theories of social practice and Thematic Framework of Acceptability guided the assessment of stakeholder priorities and tool acceptability. Results The multi-phased iterative co-creation process produced the 25-question RMC-T that measures satisfaction, communication, mistreatment (including physical, verbal, and sexual abuse; neglect; discrimination; lack of privacy; unconsented care; post-birth clean-up; informal payments; and denial of care), supportive care (such as food intake and mobility), birth companionship, post-procedure pain relief, bed-sharing, and newborn respect. The pragmatic validation process prioritized stakeholder feedback over strict statistics, lowering Cronbach’s alpha from 0.70 in version 1 to 0.57 for the RMC-T. Women valued the opportunity to share their experiences. Conclusions The RMC-T is contextualized, validated, and acceptable for measuring women’s experiences of RMC. Routine use in facility-based quality improvement initiatives, along with targeted actions to address gaps, will advance rights-based RMC. Further validation and community-based studies are needed. |
| format | Article |
| id | doaj-art-4b8bb5f386044df49b9127fa0a5d5366 |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-4b8bb5f386044df49b9127fa0a5d53662025-02-05T12:46:14ZengTaylor & Francis GroupGlobal Health Action1654-98802024-12-0117110.1080/16549716.2024.24039722403972‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban TanzaniaBrenda Sequeira D’mello0Natasha Housseine1Hussein Lesio Kidanto2Nanna Maaløe3Jos van Roosmalen4Dan Wolf Meyrowitsch5Thomas van den Akker6Zainab Muniro7Evance Polin8Nuswe Ambokile9Charles Festo10Jane Brandt Sørensen11David Sando12Comprehensive Community Based Rehabilitation in Tanzania (CCBRT)Aga Khan UniversityAga Khan UniversityUniversity of CopenhagenVU UniversityUniversity of CopenhagenVU UniversityTemeke Regional Referral HospitalTemeke Regional Referral HospitalTemeke Regional Referral HospitalIfakara Health InstituteUniversity of CopenhagenManagement and Development for Health (MDH)Background Rights-based Respectful Maternity Care (RMC) is crucial for quality of care and improved birth outcomes, yet RMC measurements are rarely included in facility improvement initiatives. We aimed to (i) co-create a routine RMC measurement tool (RMC-T) for congested maternity units in Dar es Salaam, Tanzania, and (ii) assess the RMC-T’s acceptability among women and healthcare stakeholders. Method We employed a participatory approach utilizing multiple mixed methods. This included a scoping review, stakeholder engagement involving postnatal women, healthcare providers, health leadership, and global researchers through interviews, focus groups, and two surveys involving 201 and 838 postnatal women. Cronbach’s alpha and factor analysis were conducted for validation using Stata 15. Theories of social practice and Thematic Framework of Acceptability guided the assessment of stakeholder priorities and tool acceptability. Results The multi-phased iterative co-creation process produced the 25-question RMC-T that measures satisfaction, communication, mistreatment (including physical, verbal, and sexual abuse; neglect; discrimination; lack of privacy; unconsented care; post-birth clean-up; informal payments; and denial of care), supportive care (such as food intake and mobility), birth companionship, post-procedure pain relief, bed-sharing, and newborn respect. The pragmatic validation process prioritized stakeholder feedback over strict statistics, lowering Cronbach’s alpha from 0.70 in version 1 to 0.57 for the RMC-T. Women valued the opportunity to share their experiences. Conclusions The RMC-T is contextualized, validated, and acceptable for measuring women’s experiences of RMC. Routine use in facility-based quality improvement initiatives, along with targeted actions to address gaps, will advance rights-based RMC. Further validation and community-based studies are needed.http://dx.doi.org/10.1080/16549716.2024.2403972person-centered maternity careexperience of carerespectful maternity caremeasurement tooldisrespect and abusemistreatmenturban healthdar es salaam |
| spellingShingle | Brenda Sequeira D’mello Natasha Housseine Hussein Lesio Kidanto Nanna Maaløe Jos van Roosmalen Dan Wolf Meyrowitsch Thomas van den Akker Zainab Muniro Evance Polin Nuswe Ambokile Charles Festo Jane Brandt Sørensen David Sando ‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania Global Health Action person-centered maternity care experience of care respectful maternity care measurement tool disrespect and abuse mistreatment urban health dar es salaam |
| title | ‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania |
| title_full | ‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania |
| title_fullStr | ‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania |
| title_full_unstemmed | ‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania |
| title_short | ‘I am happy to be listened to’: co-creation of a simple tool to measure women’s experiences of respectful maternity care in urban Tanzania |
| title_sort | i am happy to be listened to co creation of a simple tool to measure women s experiences of respectful maternity care in urban tanzania |
| topic | person-centered maternity care experience of care respectful maternity care measurement tool disrespect and abuse mistreatment urban health dar es salaam |
| url | http://dx.doi.org/10.1080/16549716.2024.2403972 |
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