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Analysis of the social acceptability of a humanized childbirth intervention in Senegal: A qualitative study

  • Emilie Gélinas
    Correspondence
    Correspondence to: 286 rue André-Jobin, Saint-Eustache, Québec, Canada.
    Affiliations
    Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l’Université, Rouyn-Noranda, Québec J9X 5E4, Canada
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  • Oumar Mallé Samb
    Affiliations
    Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l’Université, Rouyn-Noranda, Québec J9X 5E4, Canada
    Search for articles by this author

      Abstract

      Background

      In efforts to improve the quality of women’s care and enhance related experiences in Senegal, the Senegalese government implemented an intervention named “humanized childbirth” in their health facilities.

      Aim

      To analyze the social acceptability of humanized childbirth as well as its relevance given the social values in Senegal.

      Methods

      A multiple-case study was conducted within four health facilities in Dakar. Breastfeeding mothers (n = 20), pregnant women (n = 4), midwives (n = 8), Bajenu Gox (n = 4), members of the Health Development Committee (n = 4), and men from the community (n = 4) were interviewed individually, and a documentary analysis was done. The thematic analysis was performed using the acceptability theoretical framework.

      Findings

      The results show that most participants agreed with the idea of humanized childbirth. However, participants display varying viewpoints as to the social acceptability of various components of the intervention. While there is an overall agreement concerning the benefits of motivated and attentive health professionals focused on prevention, restoring dignity for the parturient woman, freedom to eat and drink, massages and relaxation, the same cannot be said about the freedom of choice for birth positions and companionship.

      Discussion

      The contrasting viewpoints as to the acceptability of humanized childbirth can be explained by the perception of risk and lack of experience with free birthing positions, as well as structural and cultural barriers surrounding the notion of companionship.

      Conclusion

      Education and awareness of the benefits of free birthing positions and companionship would be required among Senegalese women to enable a cultural shift in maternity wards in Senegal.

      Abbreviations:

      HDC (Health Development Committee), JICA (Japan International Cooperation Agency), NHDP (National Health Development Plan), EONC (Emergency obstetric and newborn care)

      Keywords

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      References

      1. WHO, WHO|Maternal Mortality, 2018. Available from: 〈https://www.who.int/news-room/fact-sheets/detail/maternal-mortality〉.

        • Campbell O.
        • Graham W.
        Strategies for reducing maternal mortality: getting on with what works.
        Lancet. 2006; : 368
        • Kyei-Nimakoh M.
        • Carolan-Olah M.
        • McCann T.V.
        Access barriers to obstetric care at health facilities in sub-Saharan Africa—a systematic review.
        Syst. Rev. 2017; 6: 110
      2. D. Bowser, K. Hill, Exploring Evidence for Disrespect and Abuse in Facility-based Childbirth: Report of A Landscape Analysis, USAID-TRAction Project, Washington, DC, 2010.

        • Bohren M.A.
        • Vogel J.P.
        • Hunter E.C.
        • Lutsiv O.
        • Makh S.K.
        • Souza J.P.
        • et al.
        The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review.
        PLOS Med. 2015; 12e1001847
      3. White Ribbon Alliance, Respectful Maternity Care: The Universal Rights of Childbearing Women, Maternal Health Task Force, 2011.

      4. OMS, La prévention et l’élimination du manque de respect et des mauvais traitements lors de l’accouchement dans des établissements de soins, Organisation Mondiale de la Santé, 2014.

      5. WHO, WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience, World Health Organization, 2018.

        • Smith H.
        • Brown H.
        • Hofmeyr G.J.
        • Garner P.
        Evidence-based obstetric care in South Africa—influencing practice through the ‘Better Births Initiative’.
        S. Afr. Med. J. 2004; 94: 117-120
        • Kujawski S.A.
        • Freedman L.P.
        • Ramsey K.
        • Mbaruku G.
        • Mbuyita S.
        • Moyo W.
        • et al.
        Community and health system intervention to reduce disrespect and abuse during childbirth in Tanga Region: a comparative before-and-after study.
        PLOS Med. 2017; e1002341
        • Ratcliffe H.L.
        • Sando D.
        • Lyatuu G.W.
        • Emil F.
        • Mwanyika-Sando M.
        • Chalamilla G.
        • et al.
        Mitigating disrespect and abuse during childbirth in Tanzania: an exploratory study of the effects of two facility-based interventions in a large public hospital.
        Reprod. Health. 2016; 13: 79
        • Curtin M.
        • Savage E.
        • Leahy‐Warren P.
        Humanisation in pregnancy and childbirth: a concept analysis.
        J. Clin. Nurs. 2020; 29: 1744-1757https://doi.org/10.1111/jocn.151 52
        • Behruzi R.
        • Hatem M.
        • Fraser W.
        • Goulet L.
        • Li M.
        • Misago C.
        Facilitators and barriers in the humanization of childbirth practice in Japan.
        BMC Pregnancy Childbirth. 2010; 10: 25
        • Ferrer M.B.C.
        • Jordana M.C.
        • Meseguer C.B.
        • García C.C.
        • Roche M.E.M.
        Comparative study analysing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care.
        BMJ Open. 2016; 6e011362https://doi.org/10.1136/bmjopen-2016-011362
        • Mortensen B.
        • Lieng M.
        • Diep L.M.
        • Lukasse M.
        • Atieh K.
        • Fosse E.
        Improving maternal and neonatal health by a midwife-led continuity model of care–an observational study in one governmental hospital in palestine.
        eClinicalMedicine. 2019; 10: 84-91
        • Jiang X.M.
        • Chen Q.Y.
        • Guo S.B.
        • Jin L.Z.
        • Huang X.X.
        • Liu X.W.
        • et al.
        Effect of midwife‐led care on birth outcomes of primiparas.
        Int. J. Nurs. Pract. 2018; 24e12686
        • Hofmeyr G.J.
        • Mancotywa T.
        • Silwana-Kwadjo N.
        • Mgudlwa B.
        • Lawrie T.A.
        • Gülmezoglu A.M.
        Audit of a new model of birth care for women with low risk pregnancies in South Africa: the primary care onsite midwife-led birth unit (OMBU).
        BMC Pregnancy Childbirth. 2014; 14: 417https://doi.org/10.1186/s12884-014-0417-8
        • Mselle L.T.
        • Kohi T.W.
        • Dol J.
        Barriers and facilitators to humanizing birth care in Tanzania: findings from semi-structured interviews with midwives and obstetricians.
        Reprod. Health. 2018; 15: 1-10
      6. Agence Nationale de la Statistique et de la Démographie (ANSD), La population du Sénégal en 2018, Sénégal, 2019.

      7. Groupe de la Banque mondiale, Sénégal – Vue d'ensemble 2019. Available from: 〈https://www.banquemondiale.org/fr/country/senegal/overview〉.

      8. Ministère de la santé et de la prévention médicale, Feuille de route multisectorielle pour accélérer la réduction de la mortalité et de la morbidité maternelles et néonatales au Sénégal, Sénégal, 2006.

      9. Ministère de la santé et de la prévention médicale, Arrêté ministériel no. 7507 MSP DS-DSR en date du 24 août 2010, Sénégal, 2010.

      10. Ministère de la santé et de la prévention, Plan National de Développement Sanitaire PNDS 2009–2018, Sénégal, 2009.

      11. Agence Nationale de la Statistique et de la Démographie (ANSD) [Sénégal], ICF, Sénégal: Enquête Démographique et de Santé Continue (EDS-Continue 2017), Maryland, 2017.

      12. Ministère de la santé et de l'action sociale, Soins de santé maternelle et néonatale bases sur les preuves s.d.

      13. Japan International Cooperation Agency, Activities in Senegal: Project for Reinforcement for Maternal and Newborn Health Care Phase 2 (PRESSMN 2), JICA; s.d.

        • Sekhon M.
        • Cartwright M.
        • Francis J.J.
        Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework.
        BMC Health Serv. Res. 2017; 17: 88
      14. J.L. Poupart, Entretien de type qualitatif: considérations épistémologiques, théoriques et méthodologiques, La recherche qualitative: enjeux épistémologiques et méthodologiques, 1997, pp. 173–209.

        • Paillé P.
        • Mucchielli A.
        Chapitre 11 – L’analyse thématique.
        L’analyse Qualitative En Sciences Humaines Et Sociales. Armand Colin, Paris2012: 231-314
        • Carles G.
        Grossesse, accouchement et cultures: approche transculturelle de l’obstétrique.
        J. Gynécol. Obstét. Biol. Reprod. 2014; 43 (275-80)
        • Zwelling E.
        The emergence of high-tech birthing.
        J. Obstet. Gynecol. Neonatal Nurs. 2008; 37: 85-93
        • Zileni B.D.
        • Glover P.
        • Jones M.
        • Teoh K.-K.
        • Zileni C.W.
        • Muller A.
        Malawi women’s knowledge and use of labour and birthing positions: a cross-sectional descriptive survey.
        Women Birth. 2017; 30: e1-e8
        • Okonta P.
        Birthing positions: awareness and preferences of pregnant women in a developing country.
        Internet J. Gynecol. Obstet. 2012; 16: 1
        • Lwanga H.
        • Atuyambe L.
        • Sempewo H.
        • Lumala A.
        • Byaruhanga R.
        An exploratory study of men’s companionship, perceptions and experiences during pregnancy and delivery in Uganda.
        BMC Pregnancy Childbirth. 2017; 17: 196
        • Gibore N.S.
        • Bali T.A.
        Community perspectives: an exploration of potential barriers to men’s involvement in maternity care in a central Tanzanian community.
        PLoS One. 2020; 15e0232939
        • Kassahun F.
        • Worku C.
        • Nigussie A.
        • Ganfurie G.
        Prevalence of male attendance and associated factors at their partners antenatal visits among antenatal care attendees in Bale Zone, South East Ethiopia.
        Int. J. Nurs. Midwifery. 2018; 10 (109-20)
        • Afulani P.
        • Kusi C.
        • Kirumbi L.
        • Walker D.
        Companionship during facility-based childbirth: results from a mixed-methods study with recently delivered women and providers in Kenya.
        BMC Pregnancy Childbirth. 2018; 18: 150
        • Alexander A.
        • Mustafa A.
        • Emil S.A.
        • Amekah E.
        • Engmann C.
        • Adanu R.
        • et al.
        Social support during delivery in rural central Ghana: a mixed methods study of women’s preferences for and against inclusion of a lay companion in the delivery room.
        J. Biosoc. Sci. 2014; 46: 669-685
        • Oboro V.O.
        • Oyeniran A.O.
        • Akinola S.E.
        • Isawumi A.I.
        Attitudes of Nigerian women toward the presence of their husband or partner as a support person during labor.
        Int. J. Gynecol. Obstet. 2011; 112: 56-58
        • Adeniran A.S.
        • Fawole A.A.
        • Adesina K.T.
        • Aboyeji A.P.
        • Balogun O.R.
        • Ijaiya M.A.
        Spousal participation during pregnancy and delivery in Ilorin, Nigeria.
        Med. J. Zamb. 2019; 46: 221-227
        • Mullick S.
        • Kunene B.
        • Wanjiru M.
        Involving men in maternity care: health service delivery issues.
        Agenda Spec. Focus. 2005; 6: 124-135
        • Maluka S.O.
        • Peneza A.K.
        Perceptions on male involvement in pregnancy and childbirth in Masasi District, Tanzania: a qualitative study.
        Reprod. Health. 2018; : 68
        • Dodou H.D.
        • Rodrigues D.P.
        • Guerreiro E.M.
        • Guedes M.V.C.
        • Lago P.N.D.
        • Mesquita N.S.D.
        The contribution of the companion to the humanization of delivery and birth: perceptions of puerperal women.
        Esc. Anna Nery. 2014; 18: 262-269