# Effectiveness of person-centered intervention on obstetric violence during facility-based childbirth among women who delivered in public hospitals in Southwest Ethiopia

## TL;DR

Person-centered interventions in Ethiopian hospitals reduced obstetric violence and improved respectful care during childbirth.

## Contribution

First experimental study in Ethiopia showing that person-centered interventions reduce obstetric violence.

## Key findings

- Intervention group had a 26-point decrease in obstetric violence compared to the control group.
- Respectful maternity care workshops and maternal recognition certificates significantly reduced non-consented care and physical abuse.
- Women in the intervention group with frequent provider contact had a seven-point lower OV score.

## Abstract

Obstetric violence (OV) is a significant public health issue affecting reproductive health services and maternal health outcomes. Despite studies documenting its prevalence in Ethiopia, no experimental studies have assessed intervention effects. This study evaluates person-centered interventions for OV in public hospitals in Southwest Ethiopia, using an experimental design.

A quasi-experimental study was conducted in Southwest Ethiopia involving 396 women, divided into a control group (CG; n = 198) and an intervention group (IG; n = 198). The intervention group received person-centered interventions, including respectful maternity care workshops and maternal recognition certificates, while the control group received standard care. Statistical analyses included t-tests and regression to assess the intervention’s impact on OV.

The proportion of women who utilized companions during facility-based childbirth was higher in the intervention group [25.8%; 95% confidence interval (CI): 19.6, 31.9%] than in the control group (12.1%; 95% CI: 7.5, 16.7%). The proportion of women who experienced OV decreased significantly in the intervention group compared with the control group (IG: 42.05 ± 6.97; CG: 66.45 ± 12.12; p < 0.000), with a 26.00-point decrease in the experimental group. The multivariable general linear model revealed that the mean difference (MD) of non-confidential care (MD = −3.28; 95% CI: −3.66, −2.90), undignified care (MD = −7.03; 95% CI: −7.76, −6.31), non-consented care (MD = −5.64; 95% CI: −6.35, −4.92), physical abuse (MD = −4.80; 95% CI: −5.30, −4.31), discrimination (MD = −3.37; 95% CI: −3.79, −2.94), and detention (MD = −0.28; 95% CI: −0.51, −0.05) were significantly reduced in the intervention group, with effect sizes of 0.421, 0.480, 0.380, 0.479, 0.382, and 0.014, respectively. Women in the intervention group had an OV score that was, on average, 23 points lower (β = −23.42; 95% CI: −25.40, −21.44) than those in the control group. Additionally, women in the intervention group who had frequent contact with healthcare providers experienced, on average, a seven-point lower OV score (β = −7.47; 95% CI: −4.055, 18.37) than those in the control group.

This study revealed that implementing person-centered interventions through respectful maternity care workshops, maternity open days, and maternal certificates of recognition significantly decreases the incidence of OV and ultimately promotes respectful maternal care, improving maternal healthcare services.