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Background <p>With the increasing proportion of institutional deliveries, improving the quality of maternity services is essential to ensure a positive childbirth experience. Respectful Maternity Care (RMC) has emerged as a key component in achieving this goal. This study aims to estimate the prevalence and determinants of RMC and to explore the perceptions of perinatal women and their caregivers in public health facilities of Jodhpur.</p> Methods <p>A concurrent parallel mixed-methods study was conducted among 438 perinatal women attending health facilities in Jodhpur district. Using a multistage random sampling approach, four rural and nine urban facilities were selected. Data were collected through semi-structured interviews with perinatal women and their caregivers, supplemented by in-depth interviews with those reporting lack of RMC. Quantitative data were analyzed using regression models to identify determinants of RMC, while qualitative data were thematically analyzed and triangulated with quantitative findings.</p> Results <p>Of the 438 enrolled participants, 407 completed the study. The overall prevalence of respectful maternity care (RMC) was low at 4.42%, with the domain of right to information, informed consent, and choice of preferences scoring only 12.28%. Other domains were substantially higher: protection from physical harm or ill-treatment (93.36%), never being detained at a health facility (95.08%), confidential care (92.12%), dignified care (77.64%), equal care without discrimination (86.24%), and never being denied care (78.62%). Higher parity (three or more births) emerged as a significant determinant of RMC. Mode of delivery with intervention such as episiotomy or LSCS (B=-0.222, <i>p</i> = 0.049) and the absence of a labour companion (B=-0.969, <i>p</i> = 0.006) were significantly associated with poor perception of RMC. Thematic analysis of in-depth interviews with women and caregivers highlighted experiences of physical and verbal abuse, neglect during care, and contextual factors underlying such mistreatment.</p> Conclusion <p>The study highlights that several aspects of respectful maternity care are already being practiced in public health facilities, demonstrating the potential for further improvement. Nevertheless, the overall prevalence remains low, primarily due to the limited practice of informed choice and consent. Women who underwent delivery interventions such as episiotomy or caesarean section, as well as those without a labour companion, were more likely to report poor perception of Respectful Maternity Care. The qualitative findings underscore persistent challenges of abuse and neglect, emphasizing the urgent need for system-level interventions, including sensitization of healthcare providers, strengthening accountability mechanisms, and enhancing supportive infrastructure, to ensure a positive and dignified childbirth experience.</p>

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Respectful maternity care and its determinants in public health facilities of thar desert district, India: a mixed methods approach

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Bindiya C Gowda,
  • Neeti Rustagi,
  • Ankit Mittal,
  • Prasanna Thirunavukkarasu,
  • Srikanth Srinivasan,
  • J Sachin,
  • Vijay Kumar Chattu

摘要

Background

With the increasing proportion of institutional deliveries, improving the quality of maternity services is essential to ensure a positive childbirth experience. Respectful Maternity Care (RMC) has emerged as a key component in achieving this goal. This study aims to estimate the prevalence and determinants of RMC and to explore the perceptions of perinatal women and their caregivers in public health facilities of Jodhpur.

Methods

A concurrent parallel mixed-methods study was conducted among 438 perinatal women attending health facilities in Jodhpur district. Using a multistage random sampling approach, four rural and nine urban facilities were selected. Data were collected through semi-structured interviews with perinatal women and their caregivers, supplemented by in-depth interviews with those reporting lack of RMC. Quantitative data were analyzed using regression models to identify determinants of RMC, while qualitative data were thematically analyzed and triangulated with quantitative findings.

Results

Of the 438 enrolled participants, 407 completed the study. The overall prevalence of respectful maternity care (RMC) was low at 4.42%, with the domain of right to information, informed consent, and choice of preferences scoring only 12.28%. Other domains were substantially higher: protection from physical harm or ill-treatment (93.36%), never being detained at a health facility (95.08%), confidential care (92.12%), dignified care (77.64%), equal care without discrimination (86.24%), and never being denied care (78.62%). Higher parity (three or more births) emerged as a significant determinant of RMC. Mode of delivery with intervention such as episiotomy or LSCS (B=-0.222, p = 0.049) and the absence of a labour companion (B=-0.969, p = 0.006) were significantly associated with poor perception of RMC. Thematic analysis of in-depth interviews with women and caregivers highlighted experiences of physical and verbal abuse, neglect during care, and contextual factors underlying such mistreatment.

Conclusion

The study highlights that several aspects of respectful maternity care are already being practiced in public health facilities, demonstrating the potential for further improvement. Nevertheless, the overall prevalence remains low, primarily due to the limited practice of informed choice and consent. Women who underwent delivery interventions such as episiotomy or caesarean section, as well as those without a labour companion, were more likely to report poor perception of Respectful Maternity Care. The qualitative findings underscore persistent challenges of abuse and neglect, emphasizing the urgent need for system-level interventions, including sensitization of healthcare providers, strengthening accountability mechanisms, and enhancing supportive infrastructure, to ensure a positive and dignified childbirth experience.