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BMC Medical Research Methodology
Published in: BMC Medical Research Methodology 1/2018

Open Access 01-12-2018 | Research article

Methodological development of tools to measure how women are treated during facility-based childbirth in four countries: labor observation and community survey

Authors: Meghan A. Bohren, Joshua P. Vogel, Bukola Fawole, Ernest T. Maya, Thae Maung Maung, Mamadou Diouldé Baldé, Agnes A. Oyeniran, Modupe Ogunlade, Kwame Adu-Bonsaffoh, Nwe Oo Mon, Boubacar Alpha Diallo, Abou Bangoura, Richard Adanu, Sihem Landoulsi, A. Metin Gülmezoglu, Özge Tunçalp

Published in: BMC Medical Research Methodology | Issue 1/2018

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Abstract

Background

Efforts to improve maternal health are increasingly focused on improving the quality of care provided to women at health facilities, including the promotion of respectful care and eliminating mistreatment of women during childbirth. A WHO-led multi-country research project aims to develop and validate two tools (labor observation and community survey) to measure how women are treated during facility-based childbirth. This paper describes the development process for these measurement tools, and how they were implemented in a multi-country study (Ghana, Guinea, Myanmar and Nigeria).

Methods

An iterative mixed-methods approach was used to develop two measurement tools. Methodological development was conducted in four steps: (1) initial tool development; (2) validity testing, item adjustment and piloting of paper-based tools; (3) conversion to digital, tablet-based tools; and (4) data collection and analysis. These steps included systematic reviews, primary qualitative research, mapping of existing tools, item consolidation, peer review by key stakeholders and piloting.

Results

The development, structure, administration format, and implementation of the labor observation and community survey tools are described. For the labor observations, a total of 2016 women participated: 408 in Nigeria, 682 in Guinea, and 926 in Ghana. For the community survey, a total of 2672 women participated: 561 in Nigeria, 644 in Guinea, 836 in Ghana, and 631 in Myanmar. Of the 2016 women who participated in the labor observations, 1536 women (76.2%) also participated in the community survey and have linked data: 779 in Ghana, 425 in Guinea, and 332 in Nigeria.

Conclusions

An important step to improve the quality of maternity care is to understand the magnitude and burden of mistreatment across contexts. Researchers and healthcare providers in maternal health are encouraged to use and implement these tools, to inform the development of more women-centered, respectful maternity healthcare services. By measuring the prevalence of mistreatment of women during childbirth, we will be able to design and implement programs and policies to transform maternity services.
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Metadata
Title
Methodological development of tools to measure how women are treated during facility-based childbirth in four countries: labor observation and community survey
Authors
Meghan A. Bohren
Joshua P. Vogel
Bukola Fawole
Ernest T. Maya
Thae Maung Maung
Mamadou Diouldé Baldé
Agnes A. Oyeniran
Modupe Ogunlade
Kwame Adu-Bonsaffoh
Nwe Oo Mon
Boubacar Alpha Diallo
Abou Bangoura
Richard Adanu
Sihem Landoulsi
A. Metin Gülmezoglu
Özge Tunçalp
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2018
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/s12874-018-0603-x

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