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  1. Exploring factors contributing to mistreatment of women during childbirth in West Bank, Palestine
    Dwekat IMM, Tengku Ismail TA, Ibrahim MI, Ghrayeb F
    Women Birth, 2021 Jul;34(4):344-351.
    PMID: 32684342 DOI: 10.1016/j.wombi.2020.07.004
    BACKGROUND: Respectful care during childbirth is a universal right for each woman in every health system, and mistreatment of women during childbirth is a major breach of this right.

    AIM: This study aimed to explore the views of Palestinian women and healthcare providers regarding factors contributing to the mistreatment of women during childbirth at childbirth facilities in the West Bank, Palestine.

    METHODS: A qualitative study was conducted in the West Bank, Palestine, from February 2019 to April 2019. In-depth interviews were conducted with six Palestinian women and five healthcare providers. Consent was obtained individually from each participant, and the interviews ranged from 40 to 50min. Data collection was continued until thematic saturation was reached. Open-ended questions were asked during interviews. Thematic analysis was used to interpret the data collected from the interviews.

    RESULTS: Four themes were identified with regards to the women and healthcare providers' views about factors contributing to the mistreatment of women during childbirth in the West Bank, Palestine: limitation in childbirth facilities, factors within the healthcare providers, the women themselves, and barriers within the community.

    DISCUSSION: Mistreatment of women during childbirth may occur due to the limitations of resources and staff in childbirth facilities. Some women also justified the mistreatment, and certain characteristics of the women were believed to be the factors for mistreatment.

    CONCLUSION: As the first known study of its kind in West Bank, the identified contributing factors especially the limitations of resources and staff are essential to provide good quality and respectful care at childbirth facilities.

  2. Fulltext Development and validation of a new questionnaire to measure mistreatment of women during childbirth, satisfaction of care, and perceived quality of care
    Dwekat IMM, Ismail TAT, Ibrahim MI, Ghrayeb F, Hanafi WSWM, Ghazali AK
    Midwifery, 2021 Nov;102:103076.
    PMID: 34224953 DOI: 10.1016/j.midw.2021.103076
    OBJECTIVE: This study aims to develop and validate a new questionnaire to measure mistreatment of women during childbirth and its association with satisfaction and perceived quality of care among women in West Bank, Palestine.

    RESEARCH DESIGN /SETTING: A cross-sectional validation study was conducted in middle and south of West Bank from February 2019 to June 2020. Two-hundred postpartum women were given self-administered and online questionnaire. Content and face validity were assessed. The "satisfaction of care" and "perceived quality of care" domains were analyzed using exploratory factor analysis, while items in "experience of mistreatment" domain were evaluated descriptively. Cronbach's alpha was used to assess the reliability of the questionnaire items.

    FINDINGS: The new questionnaire consisted of three domains: "satisfaction of care", "perceived quality of care", and "experience of mistreatment" during childbirth. Five new items were added and two items were removed during content validation. Another two items were deleted through face validation. Exploratory factor analysis was conducted for the "satisfaction of care" and "perceived quality of care" domains. Two factors were identified for each domain, with a factor loading of more than 0.5. Twelve items were deleted from "satisfaction of care" domain and two items from "perceived quality of care" domain. The Cronbach's alpha values for the two factors in both domains were more than 0.87. The items in the "experience of mistreatment during childbirth" domain were evaluated descriptively.

    KEY CONCLUSIONS: The new questionnaire is valid and reliable. The final questionnaire consists of 11 items for "satisfaction of care", 16 items for "perceived quality of care" and 43 items for "experience of mistreatment of women during childbirth".

  3. Fulltext Mistreatment of Women during Childbirth and Associated Factors in Northern West Bank, Palestine
    Dwekat IMM, Ismail TAT, Ibrahim MI, Ghrayeb F, Abbas E
    Int J Environ Res Public Health, 2022 Oct 13;19(20).
    PMID: 36293759 DOI: 10.3390/ijerph192013180
    Mistreatment of women during childbirth is a clear breach of women's rights during childbirth. This study aimed to determine the prevalence and associated factors of mistreatment of women during childbirth in the north of West Bank, Palestine. A cross-sectional study was conducted among 269 women within the first 16 weeks of their last vaginal childbirth to understand the childbirth events by using proportionate stratified random sampling. An Arabic valid questionnaire was used as a study instrument. Simple and multiple logistic regression analyses were conducted to determine the factors associated with each type of mistreatment. The mean age of the women was 26.5 (SD 4.77) years. The overall prevalence of mistreatment was 97.8%. There were six types of mistreatment. Nine factors were significantly associated with the occurrence of one or more types of mistreatment. Delivery at a public childbirth facility was associated with all of the six types (aAdjOR: 2.17-16.77; p-values < 0.001-0.013). Women who lived in villages (aAdjOR 2.33; p-value = 0.047), had low education (aAdjOR 5.09; p-value = 0.004), underwent induction of labour (aAdjOR 3.03; p-value = 0.001), had a long duration of labour (aAdjOR 1.10; p-value = 0.011), did not receive pain killers (aAdjOR: 2.18-3.63; p-values = 0.010-0.020), or had an episiotomy or tear (aAdjOR 5.98; p-value < 0.001) were more likely to experience one or more types of mistreatment. With every one-hour increase in the duration of labor, women were 1.099 times more likely to experience a failure to meet the professional standard of care. Women were less likely to experience mistreatment with increasing age. Women with increasing age (aAdjOR: 0.91-0.92; p-values = 0.003-0.014) and parity (aAdjOR 0.72; p-value = 0.010) were less likely to experience mistreatment. Awareness of women's fundamental rights during childbirth, making the childbirth process as normal as possible, and improving the childbirth facilities' conditions, policies, practices and working environment may decrease mistreatment occurrence.
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