METHODS: Using a qualitative descriptive design, 12 semi-structured interviews and four focus group discussions were held with mothers and fathers who were attending a postnatal clinic in the Lake Zone region of Tanzania. Mothers\' age ranged from 20 to 45 years whereas fathers\' age ranged from 25 to 60 years. Data were analyzed using a priori coding based on Bohren\'s et al. typology of the mistreatment of women during childbirth.
RESULTS: Mothers reported facing mistreatment and disrespectful maternity care through verbal abuse (harsh or rude language and judgmental or accusatory comments), failure to meet professional standards of care (refused pain relief, unconsented surgical operations, neglect, abandonment or long delays, and skilled attendant absent at time of delivery), poor rapport between women and providers (poor communication, lack of supportive care, denied husbands presence at birth, denied mobility, denied safe traditional practices, no respect for their preferred birth positions), and health system conditions and constraints (poor physical condition of facilities, supply constraints, bribery and extortion, unclear fee structures). Despite some poor care, some mothers also reported positive birthing experiences and respectful maternity care by having a skilled attendant assistance at delivery, having good communication from nurses, receiving supportive care from nurses and privacy during delivery.
CONCLUSIONS: Despite the increasing number of deliveries occurring in the hospital, there continue to be challenges in providing respectful maternity care. Humanizing birth care in Tanzania continues to have a long way to go, however, there is evidence that changes are occurring as mothers notice and report positive changes in delivery care practices.
方法:使用定性的描述性设计,与在坦桑尼亚湖区地区产后诊所就诊的父母进行了12次半结构化访谈和四次焦点小组讨论。母亲的年龄在20至45岁之间,而父亲的年龄在25至60岁之间。数据采用基于Bohren等人的先验编码进行分析。分娩期间虐待妇女的类型学。
结果:母亲报告说,由于言语虐待(苛刻或粗鲁的语言以及判断或指责性的评论),母亲面临虐待和不尊重产妇的护理,未能达到专业护理标准(拒绝缓解疼痛,未经同意的外科手术,疏忽,放弃或长期拖延,和熟练的服务员在交付时缺席),妇女和提供者之间的融洽关系差(沟通差,缺乏支持性护理,否认丈夫出生时在场,拒绝流动性,否认安全的传统做法,不尊重他们的首选出生位置),和卫生系统条件和制约因素(设施物理条件差,供应限制,贿赂和敲诈勒索,费用结构不明确)。尽管有一些可怜的照顾,一些母亲还报告了积极的分娩经历和尊重产妇的护理,在分娩时得到了熟练的服务员援助,有护士的良好沟通,在分娩期间接受护士的支持性护理和隐私。
结论:尽管医院分娩的数量不断增加,在提供尊重的产妇护理方面仍然存在挑战。坦桑尼亚的人性化生育护理还有很长的路要走,然而,有证据表明,随着母亲注意到并报告分娩护理实践的积极变化,变化正在发生。