Phyllis Dako-Gyeke | University of Arkansas (original) (raw)
Papers by Phyllis Dako-Gyeke
Ghana Medical Journal, 2015
Background: Later years of life are accompanied by many physical, emotional and environmental cha... more Background: Later years of life are accompanied by many physical, emotional and environmental changes which may impact on the well-being of the individual. Many factors are known to influence the subjective well-being of older adults, but most, if not all of this information was the result of studies in the Western world. This study aimed at obtaining and documenting the predictors of subjective well-being (SWB) among older Ghanaians. Methods: Data for the study was obtained from the WHO SAGE study. The single item measure of life satisfaction was used to determine subjective wellbeing. Descriptive statistics as well as logistic regression analysis were carried out to determine the predictors of SWB. Results: A total of 4724 individuals aged 50 years and above responded to the questionnaires. Of these 50.4% were males. Following multivariate logistic regression analysis, age, sex, educational level, income and ethnic background were found to significantly affect the SWB of older Ghanaians. Being male was associated with higher level of SWB (OR=1.68; CI: 1.39-2.03). For those 50 years and above, being younger (50-59 years) was also associated with a high level of SWB (OR=17.72; CI: 10.13-30.98). Earning a low income and having low educational level were both associated with low levels of SWB (OR=0.304; CI: 0.22-0.42; and OR=0.47; CI: 0.37-0.60 respectively). Ewes (p=0.027), Grumas (p=0.002) and Mole-Dagbons (p=0.04) had significantly higher SWB compared to the other ethnic groups. Conclusion: Among older Ghanaians, factors that positively influence SWB are younger age, male sex, high educational level and high income.
PLOS ONE, 2021
Background Early Infant Diagnosis (EID) of HIV and timely initiation of Antiretroviral Therapy (A... more Background Early Infant Diagnosis (EID) of HIV and timely initiation of Antiretroviral Therapy (ART) can significantly reduce morbidity and mortality of HIV infected infants. Despite the benefits of early infant testing, the coverage of EID of HIV services is still low in Sub-Saharan Africa, including Ghana. Objectives To ascertain the factors that facilitate or hinder the delivery and uptake of EID of HIV services. Methods The study is a cross-sectional exploratory qualitative research conducted in two health facilities in the Greater Accra Region of Ghana. Respondents (n = 50) comprising health workers (n = 20) and HIV positive mothers (n = 30) were purposively sampled and engaged in in-depth interviews. The Nvivo 11 software and the Braun and Clarke’s stages of thematic analysis were used in coding data and data analysis respectively. Results The study found that health system factors such as inadequate Staff with sample collection skills, unavailability of vehicles to convey sam...
Questionnaire on glaucoma awareness, knowledge. (DOCX 75 kb)
Questionnaire validation procedure on glaucoma awareness. (DOCX 12 kb)
Background Exclusive Breastfeeding (EBF) is globally accepted as the preferred method for infant ... more Background Exclusive Breastfeeding (EBF) is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children < 2 months old are exclusively breastfed. But by age 4 to 5 months, only 49% continue to receive EBF. This situation continues to deteriorate. Thus, the need to explore perceptions, practices as well as factors that influence EBF in Ghana. Method Using a qualitative design, four focus group discussions were conducted among first-time mothers and eight in-depth interviews with health workers and traditional birth attendants. The study was conducted in four communities in the Kassena-Nankana municipality of Ghana. Discussions and interviews were recorded and later transcribed verbatim to English language. The transcribed data was then coded with the aid of analysis computer software (Nvivo version 10.0) and later analyzed for the generation of themes. Result Exclusive breastfeeding is practiced among first-time mothers due to its perceived...
Infectious Diseases of Poverty, 2020
Universal health coverage emphasises the value of the community-based delivery of health services... more Universal health coverage emphasises the value of the community-based delivery of health services to ensure that underserved populations have access to care. In areas where infectious diseases are endemic, there are often few resources and limited capacity, and the introduction of effective and accessible strategies require innovation. In this special issue, the contributing authors emphasise the power of local responses to the circumstances that underpin diseases of poverty, and highlight the methodological and programme innovations necessary to support and sustain these responses. Through case studies, the authors illustrate how social innovations can address health inequities, and they identify the role of academics in the Social Innovation in Health Initiative to support this approach.
Health Research Policy and Systems, 2020
Background Implementation research is increasingly being recognised as an important discipline se... more Background Implementation research is increasingly being recognised as an important discipline seeking to maximise the benefits of evidence-based interventions. Although capacity-building efforts are ongoing, there has been limited attention on the contextual and health system peculiarities in low- and middle-income countries. Moreover, given the challenges encountered during the implementation of health interventions, the field of implementation research requires a creative attempt to build expertise for health researchers and practitioners simultaneously. With support from the Special Programme for Research and Training in Tropical Diseases, we have developed an implementation research short course that targets both researchers and practitioners. This paper seeks to explain the course development processes and report on training evaluations, highlighting its relevance for inter-institutional and inter-regional capacity strengthening. Methods The development of the implementation r...
Gates Open Research, 2019
Background: Despite the presence of legal abortion services in Ghana, unsafe abortion remains com... more Background: Despite the presence of legal abortion services in Ghana, unsafe abortion remains common, particularly among young women. Little is understood about what young people know about safe and legal abortion, and if and how they are utilizing it. Methods: To characterize abortion use and address gaps in safe access, from September-December 2013, we conducted a cross-sectional survey with 100 men and 250 women aged 18-24 in Accra, Ghana. Participants were asked about abortion experiences, including prior services, providers, methods, satisfaction, perceived support, and knowledge of laws. Descriptive statistics, Fisher’s exact tests, and chi-square tests were performed. Results: Among surveyed youth, most (87% of women, 64% of men) thought abortion was illegal or did not know the law. In total, 30% of women and 14% of men ever had an abortion and partner who had an abortion, respectively. Among women’s most recent abortions, medication abortion (61%), surgical methods (26%), an...
Globalization and Health, 2019
PloS one, 2018
The objective of this study was to determine factors associated with modern contraceptive use and... more The objective of this study was to determine factors associated with modern contraceptive use and unintended pregnancy among young women and men in Accra, Ghana. From September-December 2013, we conducted a cross-sectional survey with 250 women and 100 men aged 18-24. We explored determinants of modern contraceptive use among males and females and unintended pregnancy among females. Descriptive statistics, chi-square tests, Fisher's exact tests, and multivariable logistic regression were used. Participants had an average of three lifetime sexual partners, and 91% had one current partner. Overall, 44% reported current modern contraceptive use. In multivariate modeling, modern contraceptive use was associated with higher education compared to primary (AORs 2.1-4.3); ever talking with someone about contraception (AOR 4.7); feeling unsupported by a healthcare provider for contraception (AOR 2.2); and not feeling at risk of unintended pregnancy (AOR 2.7). While ≥70% of participants r...
Reproductive Health Matters, 2018
Lacoste translated abstracts from English to French and Lisette Silva translated abstracts from E... more Lacoste translated abstracts from English to French and Lisette Silva translated abstracts from English to Spanish.
Reproductive Health Matters, 2018
Mistreatment of women during childbirth at health facilities violates their human rights and auto... more Mistreatment of women during childbirth at health facilities violates their human rights and autonomy and may be associated with preventable maternal and newborn mortality and morbidity. In this paper, we explore women's perspectives on mistreatment during facility-based childbirth as part of a bigger World Health Organization (WHO) multi-country study for developing consensus definitions, and validating indicators and tools for measuring the burden of the phenomenon. Focus group discussions (FGDs) and indepth interviews (IDIs) were used to explore experiences of mistreatment from women who have ever given birth in a health facility in Koforidua and Nsawam, Ghana. Interviews were audio-recorded, transcribed and thematic analysis conducted. A total of 39 IDIs and 10 FGDs involving 110 women in total were conducted. The major types of mistreatment identified were: verbal abuse (shouting, insults, and derogatory remarks), physical abuse (pinching, slapping) and abandonment and lack of support. Mistreatment was commonly experienced during the second stage of labour, especially amongst adolescents. Inability to push well during the second stage, disobedience to instructions from birth attendants, and not bringing prescribed items for childbirth (mama kit) often preceded mistreatment. Most women indicated that slapping and pinching were acceptable means to "correct" disobedient behaviours and encourage pushing. Women may avoid giving birth in health facilities in the future because of their own experiences of mistreatment, or hearing about another woman's experience of mistreatment. Consensus definitions, validated indicators and tools for measuring mistreatment are needed to measure prevalence and identify drivers and potential entry points to minimise the phenomenon and improve respectful care during childbirth.
BMC Ophthalmology, 2016
Background: Although glaucoma is the lead cause of irreversible blindness globally, the condition... more Background: Although glaucoma is the lead cause of irreversible blindness globally, the condition shows no signs or symptoms until later stages. Knowledge about the disease is known to influence utilization of eye screening services. This study aimed at understanding knowledge and perception of risk for glaucoma, as well as eye screening behaviour among residents of Abokobi, a peri-urban community. Methods: This was a cross-sectional study that employed quantitative data collection methods, with the use of a questionnaire. Descriptive statistics were used to describe the socio-demographic characteristics, knowledge about glaucoma and eye screening behaviour. Also, associations between socio-demographic factors and awareness as well as perception of risk were analysed using Chi-square test or Univariate Fisher's exact test. Results: Out of a total of 300 respondents, 60.3 % were females and 39.3 % were aware of glaucoma. Majority (99.1 %) of respondents aware of glaucoma also agreed the disease can result in blindness with only (28 %) affirming that blindness from glaucoma is irreversible. Nearly half (49.7 %) of the respondents perceived themselves to be at risk of developing glaucoma. The results showed that age and education (p <0.0001) were statistically significant with glaucoma awareness. Approximately, 20.7 % of the respondents have had their eye screened with just a few (4.3 %) screening for glaucoma. Conclusion: Although glaucoma awareness was high, the findings display inadequate knowledge about glaucoma. There is a need to effectively inform and educate people about the disease.
Reproductive Health, 2017
Background: Alcohol consumption among pregnant women is a public health concern, considering its ... more Background: Alcohol consumption among pregnant women is a public health concern, considering its adverse outcomes for both mother and the developing foetus. This study examined factors that facilitate prenatal alcohol consumption, knowledge of adverse outcomes of prenatal alcohol exposure and alcohol expenditure among pregnant women in an urban community in Ghana. Methods: In June 2014, a survey was conducted among 250 pregnant women sampled from James Town, an urban community in the Greater Accra Region of Ghana. Data were collected through face-to-face interviews and descriptive statistics conducted. The prevalence of alcohol consumption among women was determined. Pearson chi-square was used to determine associations between variables where necessary. Results: Fifty-four percent of the pregnant women were aged 20-29 years. Seventy-three percent reported that they have ever consumed an alcoholic beverage before pregnancy. Of these, 77% take alcohol "once a while" and 48% reported taking alcohol during pregnancy. Most of the pregnant women (53%) who currently consume alcoholic beverages had it from friends, and their main reason for prenatal alcohol consumption was socialization (39%). Majority of both current alcohol drinkers (78%) and non-current alcohol drinkers (74%) were aware that prenatal alcohol consumption can lead to spontaneous abortion. Additionally, current alcohol drinkers spend averagely GHS 4.54 (SD 4.63) on their favourite alcoholic drink and overall, also spend averagely GHS 4.63 (SD 4.82) on their entire alcoholic beverage weekly. Over two-thirds (63%) of women reported monthly average income of less than GHS200. Conclusion: This study shows high prenatal alcohol consumption in James Town, Accra, despite pregnant women's knowledge of its adverse effects on the developing foetus. Alcohol is usually sourced from friends with socialization noted as a major reason for prenatal alcohol consumption. These results could be used to inform future health advocacies and policies on prenatal alcohol exposure and maternal and child health interventions in the country.
Reproductive Health, 2015
Background: Every woman has the right to dignified, respectful care during childbirth. Recent evi... more Background: Every woman has the right to dignified, respectful care during childbirth. Recent evidence has demonstrated that globally many women experience mistreatment during labour and childbirth in health facilities, which can pose a significant barrier to women attending facilities for delivery and can contribute to poor birth experiences and adverse outcomes for women and newborns. However there is no clear consensus on how mistreatment of women during childbirth in facilities is defined and measured. We propose using a two-phased, mixed-methods study design in four countries to address these research gaps. This protocol describes the Phase 1 qualitative research activities. Methods/Design: We will employ qualitative research methodologies among women, healthcare providers and administrators in the facility catchment areas of two health facilities in each country: Ghana, Guinea, Myanmar and Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) will be conducted among women of reproductive age (15-49 years) to explore their perceptions and experiences of facility-based childbirth care, focused on how they were treated by healthcare workers and perceived factors affecting how they were treated. IDIs will also be conducted with healthcare providers of different cadres (e.g.: nurses, midwives, medical officers, specialist obstetricians) and facility administrators working in the selected facilities to explore healthcare providers' perceptions and experiences of facility-based childbirth care and how staff are treated, colleagues and supervisors. Audio recordings will be transcribed and translated to English. Textual data will be analysed using a thematic framework approach and will consist of two levels of analysis: (1) conduct of local analysis workshops with the research assistants in each country; and (2) line-by-line coding to develop a thematic framework and coding scheme.
Ghana Medical Journal, 2015
Background: Later years of life are accompanied by many physical, emotional and environmental cha... more Background: Later years of life are accompanied by many physical, emotional and environmental changes which may impact on the well-being of the individual. Many factors are known to influence the subjective well-being of older adults, but most, if not all of this information was the result of studies in the Western world. This study aimed at obtaining and documenting the predictors of subjective well-being (SWB) among older Ghanaians. Methods: Data for the study was obtained from the WHO SAGE study. The single item measure of life satisfaction was used to determine subjective wellbeing. Descriptive statistics as well as logistic regression analysis were carried out to determine the predictors of SWB. Results: A total of 4724 individuals aged 50 years and above responded to the questionnaires. Of these 50.4% were males. Following multivariate logistic regression analysis, age, sex, educational level, income and ethnic background were found to significantly affect the SWB of older Ghanaians. Being male was associated with higher level of SWB (OR=1.68; CI: 1.39-2.03). For those 50 years and above, being younger (50-59 years) was also associated with a high level of SWB (OR=17.72; CI: 10.13-30.98). Earning a low income and having low educational level were both associated with low levels of SWB (OR=0.304; CI: 0.22-0.42; and OR=0.47; CI: 0.37-0.60 respectively). Ewes (p=0.027), Grumas (p=0.002) and Mole-Dagbons (p=0.04) had significantly higher SWB compared to the other ethnic groups. Conclusion: Among older Ghanaians, factors that positively influence SWB are younger age, male sex, high educational level and high income.
PLOS ONE, 2021
Background Early Infant Diagnosis (EID) of HIV and timely initiation of Antiretroviral Therapy (A... more Background Early Infant Diagnosis (EID) of HIV and timely initiation of Antiretroviral Therapy (ART) can significantly reduce morbidity and mortality of HIV infected infants. Despite the benefits of early infant testing, the coverage of EID of HIV services is still low in Sub-Saharan Africa, including Ghana. Objectives To ascertain the factors that facilitate or hinder the delivery and uptake of EID of HIV services. Methods The study is a cross-sectional exploratory qualitative research conducted in two health facilities in the Greater Accra Region of Ghana. Respondents (n = 50) comprising health workers (n = 20) and HIV positive mothers (n = 30) were purposively sampled and engaged in in-depth interviews. The Nvivo 11 software and the Braun and Clarke’s stages of thematic analysis were used in coding data and data analysis respectively. Results The study found that health system factors such as inadequate Staff with sample collection skills, unavailability of vehicles to convey sam...
Questionnaire on glaucoma awareness, knowledge. (DOCX 75 kb)
Questionnaire validation procedure on glaucoma awareness. (DOCX 12 kb)
Background Exclusive Breastfeeding (EBF) is globally accepted as the preferred method for infant ... more Background Exclusive Breastfeeding (EBF) is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children < 2 months old are exclusively breastfed. But by age 4 to 5 months, only 49% continue to receive EBF. This situation continues to deteriorate. Thus, the need to explore perceptions, practices as well as factors that influence EBF in Ghana. Method Using a qualitative design, four focus group discussions were conducted among first-time mothers and eight in-depth interviews with health workers and traditional birth attendants. The study was conducted in four communities in the Kassena-Nankana municipality of Ghana. Discussions and interviews were recorded and later transcribed verbatim to English language. The transcribed data was then coded with the aid of analysis computer software (Nvivo version 10.0) and later analyzed for the generation of themes. Result Exclusive breastfeeding is practiced among first-time mothers due to its perceived...
Infectious Diseases of Poverty, 2020
Universal health coverage emphasises the value of the community-based delivery of health services... more Universal health coverage emphasises the value of the community-based delivery of health services to ensure that underserved populations have access to care. In areas where infectious diseases are endemic, there are often few resources and limited capacity, and the introduction of effective and accessible strategies require innovation. In this special issue, the contributing authors emphasise the power of local responses to the circumstances that underpin diseases of poverty, and highlight the methodological and programme innovations necessary to support and sustain these responses. Through case studies, the authors illustrate how social innovations can address health inequities, and they identify the role of academics in the Social Innovation in Health Initiative to support this approach.
Health Research Policy and Systems, 2020
Background Implementation research is increasingly being recognised as an important discipline se... more Background Implementation research is increasingly being recognised as an important discipline seeking to maximise the benefits of evidence-based interventions. Although capacity-building efforts are ongoing, there has been limited attention on the contextual and health system peculiarities in low- and middle-income countries. Moreover, given the challenges encountered during the implementation of health interventions, the field of implementation research requires a creative attempt to build expertise for health researchers and practitioners simultaneously. With support from the Special Programme for Research and Training in Tropical Diseases, we have developed an implementation research short course that targets both researchers and practitioners. This paper seeks to explain the course development processes and report on training evaluations, highlighting its relevance for inter-institutional and inter-regional capacity strengthening. Methods The development of the implementation r...
Gates Open Research, 2019
Background: Despite the presence of legal abortion services in Ghana, unsafe abortion remains com... more Background: Despite the presence of legal abortion services in Ghana, unsafe abortion remains common, particularly among young women. Little is understood about what young people know about safe and legal abortion, and if and how they are utilizing it. Methods: To characterize abortion use and address gaps in safe access, from September-December 2013, we conducted a cross-sectional survey with 100 men and 250 women aged 18-24 in Accra, Ghana. Participants were asked about abortion experiences, including prior services, providers, methods, satisfaction, perceived support, and knowledge of laws. Descriptive statistics, Fisher’s exact tests, and chi-square tests were performed. Results: Among surveyed youth, most (87% of women, 64% of men) thought abortion was illegal or did not know the law. In total, 30% of women and 14% of men ever had an abortion and partner who had an abortion, respectively. Among women’s most recent abortions, medication abortion (61%), surgical methods (26%), an...
Globalization and Health, 2019
PloS one, 2018
The objective of this study was to determine factors associated with modern contraceptive use and... more The objective of this study was to determine factors associated with modern contraceptive use and unintended pregnancy among young women and men in Accra, Ghana. From September-December 2013, we conducted a cross-sectional survey with 250 women and 100 men aged 18-24. We explored determinants of modern contraceptive use among males and females and unintended pregnancy among females. Descriptive statistics, chi-square tests, Fisher's exact tests, and multivariable logistic regression were used. Participants had an average of three lifetime sexual partners, and 91% had one current partner. Overall, 44% reported current modern contraceptive use. In multivariate modeling, modern contraceptive use was associated with higher education compared to primary (AORs 2.1-4.3); ever talking with someone about contraception (AOR 4.7); feeling unsupported by a healthcare provider for contraception (AOR 2.2); and not feeling at risk of unintended pregnancy (AOR 2.7). While ≥70% of participants r...
Reproductive Health Matters, 2018
Lacoste translated abstracts from English to French and Lisette Silva translated abstracts from E... more Lacoste translated abstracts from English to French and Lisette Silva translated abstracts from English to Spanish.
Reproductive Health Matters, 2018
Mistreatment of women during childbirth at health facilities violates their human rights and auto... more Mistreatment of women during childbirth at health facilities violates their human rights and autonomy and may be associated with preventable maternal and newborn mortality and morbidity. In this paper, we explore women's perspectives on mistreatment during facility-based childbirth as part of a bigger World Health Organization (WHO) multi-country study for developing consensus definitions, and validating indicators and tools for measuring the burden of the phenomenon. Focus group discussions (FGDs) and indepth interviews (IDIs) were used to explore experiences of mistreatment from women who have ever given birth in a health facility in Koforidua and Nsawam, Ghana. Interviews were audio-recorded, transcribed and thematic analysis conducted. A total of 39 IDIs and 10 FGDs involving 110 women in total were conducted. The major types of mistreatment identified were: verbal abuse (shouting, insults, and derogatory remarks), physical abuse (pinching, slapping) and abandonment and lack of support. Mistreatment was commonly experienced during the second stage of labour, especially amongst adolescents. Inability to push well during the second stage, disobedience to instructions from birth attendants, and not bringing prescribed items for childbirth (mama kit) often preceded mistreatment. Most women indicated that slapping and pinching were acceptable means to "correct" disobedient behaviours and encourage pushing. Women may avoid giving birth in health facilities in the future because of their own experiences of mistreatment, or hearing about another woman's experience of mistreatment. Consensus definitions, validated indicators and tools for measuring mistreatment are needed to measure prevalence and identify drivers and potential entry points to minimise the phenomenon and improve respectful care during childbirth.
BMC Ophthalmology, 2016
Background: Although glaucoma is the lead cause of irreversible blindness globally, the condition... more Background: Although glaucoma is the lead cause of irreversible blindness globally, the condition shows no signs or symptoms until later stages. Knowledge about the disease is known to influence utilization of eye screening services. This study aimed at understanding knowledge and perception of risk for glaucoma, as well as eye screening behaviour among residents of Abokobi, a peri-urban community. Methods: This was a cross-sectional study that employed quantitative data collection methods, with the use of a questionnaire. Descriptive statistics were used to describe the socio-demographic characteristics, knowledge about glaucoma and eye screening behaviour. Also, associations between socio-demographic factors and awareness as well as perception of risk were analysed using Chi-square test or Univariate Fisher's exact test. Results: Out of a total of 300 respondents, 60.3 % were females and 39.3 % were aware of glaucoma. Majority (99.1 %) of respondents aware of glaucoma also agreed the disease can result in blindness with only (28 %) affirming that blindness from glaucoma is irreversible. Nearly half (49.7 %) of the respondents perceived themselves to be at risk of developing glaucoma. The results showed that age and education (p <0.0001) were statistically significant with glaucoma awareness. Approximately, 20.7 % of the respondents have had their eye screened with just a few (4.3 %) screening for glaucoma. Conclusion: Although glaucoma awareness was high, the findings display inadequate knowledge about glaucoma. There is a need to effectively inform and educate people about the disease.
Reproductive Health, 2017
Background: Alcohol consumption among pregnant women is a public health concern, considering its ... more Background: Alcohol consumption among pregnant women is a public health concern, considering its adverse outcomes for both mother and the developing foetus. This study examined factors that facilitate prenatal alcohol consumption, knowledge of adverse outcomes of prenatal alcohol exposure and alcohol expenditure among pregnant women in an urban community in Ghana. Methods: In June 2014, a survey was conducted among 250 pregnant women sampled from James Town, an urban community in the Greater Accra Region of Ghana. Data were collected through face-to-face interviews and descriptive statistics conducted. The prevalence of alcohol consumption among women was determined. Pearson chi-square was used to determine associations between variables where necessary. Results: Fifty-four percent of the pregnant women were aged 20-29 years. Seventy-three percent reported that they have ever consumed an alcoholic beverage before pregnancy. Of these, 77% take alcohol "once a while" and 48% reported taking alcohol during pregnancy. Most of the pregnant women (53%) who currently consume alcoholic beverages had it from friends, and their main reason for prenatal alcohol consumption was socialization (39%). Majority of both current alcohol drinkers (78%) and non-current alcohol drinkers (74%) were aware that prenatal alcohol consumption can lead to spontaneous abortion. Additionally, current alcohol drinkers spend averagely GHS 4.54 (SD 4.63) on their favourite alcoholic drink and overall, also spend averagely GHS 4.63 (SD 4.82) on their entire alcoholic beverage weekly. Over two-thirds (63%) of women reported monthly average income of less than GHS200. Conclusion: This study shows high prenatal alcohol consumption in James Town, Accra, despite pregnant women's knowledge of its adverse effects on the developing foetus. Alcohol is usually sourced from friends with socialization noted as a major reason for prenatal alcohol consumption. These results could be used to inform future health advocacies and policies on prenatal alcohol exposure and maternal and child health interventions in the country.
Reproductive Health, 2015
Background: Every woman has the right to dignified, respectful care during childbirth. Recent evi... more Background: Every woman has the right to dignified, respectful care during childbirth. Recent evidence has demonstrated that globally many women experience mistreatment during labour and childbirth in health facilities, which can pose a significant barrier to women attending facilities for delivery and can contribute to poor birth experiences and adverse outcomes for women and newborns. However there is no clear consensus on how mistreatment of women during childbirth in facilities is defined and measured. We propose using a two-phased, mixed-methods study design in four countries to address these research gaps. This protocol describes the Phase 1 qualitative research activities. Methods/Design: We will employ qualitative research methodologies among women, healthcare providers and administrators in the facility catchment areas of two health facilities in each country: Ghana, Guinea, Myanmar and Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) will be conducted among women of reproductive age (15-49 years) to explore their perceptions and experiences of facility-based childbirth care, focused on how they were treated by healthcare workers and perceived factors affecting how they were treated. IDIs will also be conducted with healthcare providers of different cadres (e.g.: nurses, midwives, medical officers, specialist obstetricians) and facility administrators working in the selected facilities to explore healthcare providers' perceptions and experiences of facility-based childbirth care and how staff are treated, colleagues and supervisors. Audio recordings will be transcribed and translated to English. Textual data will be analysed using a thematic framework approach and will consist of two levels of analysis: (1) conduct of local analysis workshops with the research assistants in each country; and (2) line-by-line coding to develop a thematic framework and coding scheme.