Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Dr. Chinaro Kennedy

Abstract

Sierra Leone faces immense challenges in supporting good quality, woman-centered care, with one of the world's highest maternal mortality ratios of 717 per 100,000 live births. In countries with high maternal mortality, evidence of the fear of disrespect and abuse women usually confront in maternity care is a more solid deterrent to the use of skilled care than commonly recognized barriers, such as cost or distance. This qualitative phenomenological study aimed at understanding the childbirth experiences and perceptions of Sierra Leonean women relating to basic maternal rights. The ecological systems theoretical framework and the respectful maternity care charter conceptual framework guided the study. Data collection involved in-depth semi structured interviews conducted in religious settings with 21 postpartum women aged 18 to 45 years in three district hospitals in Northern Sierra Leone. The data were analyzed using the content analysis method. Thirteen themes were identified as relevant to the two research questions: accountability, empowerment, participation, sustainability, transparency, support factors, maternal care setting, healthcare providers' behavior, social factors, conflict in healthcare facilities, and factors that impact women's decision making. Participants reported diverse experiences of healthcare facility-based childbirths. Some shared that poor quality care is characterized by abuse and mistreatment and, consequently, negative implications; others reported quality care and positive impacts on care. Any approach to prevent and eliminate the identified bad and negative practices to enhance quality maternal care can contribute to positive social change. The study offers recommendations for relevant stakeholders' action and further research.

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