Disrespect And Abuse Of Women During Pregnancy And The Effects On The Utilization Of Ante Natal Care Services: A Case Of Jaramogi Oginga Odinga Teaching And Referral Hospital In Kisumu County

Abstract

Disrespect and Abuse during pregnancy is a gross violation of human and women’s rights and constitutes gender-based violence. D&A has received attention globally with studies confirming its effects on maternal and neonatal mortality. However, these works have not addressed D&A during antenatal care (ANC) services as a possible contributor to poor ANC attendance ultimately leading to unskilled birth attendance. Increasing the proportion of women delivering in facility consequently remains a challenge necessitating effort to change the status quo. The study was conducted in JOOTRH, in Kisumu County in Kenya, in the month of April 2019. The study employed cross-sectional survey to establish the different forms of D&A and their impact on ANC uptake. For quantitative data 111 women were interviewed using a structured questionnaire. Further, 4 providers and 6 women participated in Key informant interview and case narratives respectively. The most common forms of D&A in the health facility are long delays before being attended, discrimination based on age, ethnicity, health or socio-economic status, lack of necessary supplies at the facility, use of harsh or rude language by the service providers and poor physical condition of facilities. D&A then leads to miscarriages and general negative pregnancy outcomes resulting in increased exposure to unskilled care and high maternal mortality rates. To deal with D&A, expectant women change health facilities, report to the authorities, seek counselling services, avoid starting ANC early and reduce frequency of visit to the health facility or avoid ANC services all together. D&A during childbearing is highly prevalent in JOOTRH. The findings indicate that the situation is contributed to largely by fatigue brought about by high workload and lack of necessary supplies and equipment a consequence of unmatched investment in health care by the county government in the era of increased demand for service due to free service brought about by UHC. If D&A is not taken seriously, maternal and neonatal mortality rate that has plagued Kenya remains a mirage. The study recommends the training of providers to treat the service users in ways that encourage them to seek skilled care.