Measuring Person-Centered Maternity Care and developmental outcomes in children in a peri-urban setting in Kenya

Disrespect and abuse of women during labor and delivery continues to be a significant problem in low and middle-income countries, including in sub-Saharan Africa. Some scholars have argued that dignified care in this key developmental transition may have lasting positive effects on women and children. The current study examines these hypotheses by proposing a mixed-method examination of person-centered maternity care (PCMC) in a peri-urban setting in Kenya, to assess the association between PCMC and maternal adversity, mental health, and infant development.

The results of the qualitative study identified four themes related to the measurement of person-centered maternity care. Women in this informal settlement setting had positive experiences when care was person-centered – i.e., responsive, dignified, supportive, and with respectful communication. They had negative experiences when they were mistreated, which was manifested as non-responsive care (including poor reception and long wait times), non-dignified care (including verbal and physical abuse lack of privacy and confidentiality), lack of respectful communication and lack of supportive care (including being denied companions, neglect and abandonment, and poor facility environment). The quantitative study determined that women who are literate had the highest mean PCMC scores indicating high-quality care. Women whose delivery was undertaken by an unskilled birth attendant or an auxiliary nurse/midwife, women who had delayed prenatal care and women who were interviewed by phone had lower PCMC scores.

To sustain the gains in increased access to facility-based births, there is a need to improve PCMC to ensure women have a positive facility-based childbirth experience. In the fall of 2020, research team is in the process of conducting assessments of children tracked longitudinally within this study nine months later to assess any intergenerational effects of PCMC using the Bayley Scales of Infant Development. This study will continue through January 2021. 

Partners: Brother Andre Medical Center (Kenya), Holy Cross Parish (Kenya), University of California San Francisco