Neglected and non-consented care during childbirth in public health facilities in Central Tigray, Ethiopia

BACKGROUND: The present study aimed to assess the magnitude and factors associated with neglected and non-consented care during childbirth in public health facilities in Central Tigray, Ethiopia. METHODS: A health facility-based cross-sectional survey supplemented by a qualitative study was conducted from April to May 2020 among women giving birth. We included 415 participants and recruited via a systematic random sampling technique. To collect the data, a pre-tested, face-to-face exit interview using an interviewer-administered structured questionnaire was used. Neglected and non-consented care and its outcomes (yes and no) were the dependent variables, and Socio-demographic data such as (age, educational level, region, and income), and other variables associated with compassionate and respective maternity care were the independent variables. We applied bivariate and multivariate logistic regression to determine predictors for non-consented and non-confidential care components of disrespect or abuse. The in-depth interviews were analyzed using content analysis. RESULTS: Among the participants, 82.4% and 78.6% had neglected care and non-consented care among women giving birth respectively. No formal education level (AOR: 0.37, 95%, CI (0.18–0.78)) and primary education level (AOR: 0.18, 95%, CI (0.05–0.57))., mode of delivery (AOR 3.79, 95% CI 1.42–10.09), sex of skilled healthcare providers (AOR: 0.56, 95%, CI (0.34–0.93)), number of deliveries in a health Centre (AOR: 1.89, 95% CI (1.03–3.47)) predicted non-consented care, and history ANC (AOR: 8.10, 95% CI (1.33–49.51)), and federal government employee (AOR: 0.24, 95% CI (0.07–0.78)) predicted neglected care during childbirth. In-depth interview result shows the mode of delivery and sex of healthcare providers were factor associated with non-consented care and women's stay at health facilities were factor associated with neglected care. CONCLUSION: The level of neglected and non-consented care during delivery was high reflecting substantial mistreatment. Educational level, mode of delivery, sex of skilled healthcare providers, and the number of deliveries in a health Centre were associated with non-consented care, and history ANC and Federal Government employees were associated with neglected care during childbirth. These findings imply the urgent needs or intervention including strengthening of awareness of both patients and healthcare providers on patients' rights and responsibilities and training service providers in patient-centered care and interpersonal communication and relationships to minimize mistreatment.