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    The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

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    Author
    Bohren, MA; Vogel, JP; Hunter, EC; Lutsiv, O; Makh, SK; Souza, JP; Aguiar, C; Coneglian, FS; Luiz, A; Diniz, A; ...
    Date
    2015-06-01
    Source Title
    PLoS Medicine
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Bohren, Meghan; Vogel, Joshua
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Bohren, M. A., Vogel, J. P., Hunter, E. C., Lutsiv, O., Makh, S. K., Souza, J. P., Aguiar, C., Coneglian, F. S., Luiz, A., Diniz, A., Tuncalp, O., Javadi, D., Oladapo, O. T., Khosla, R., Hindin, M. J. & Guelmezoglu, A. M. (2015). The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review. PLOS MEDICINE, 12 (6), https://doi.org/10.1371/journal.pmed.1001847.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253336
    DOI
    10.1371/journal.pmed.1001847
    Abstract
    BACKGROUND: Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. METHODS AND FINDINGS: We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. CONCLUSIONS: This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.

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