N ACCESS Citation: Abuya T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. (2015) Exploring the Prevalence of Disrespect and Abuse during Childbirth in Kenya. PLoS ONE 10(4): e0123606. doi:10.1371/ journal.pone.0123606 Academic Editor: David W. Dowdy, Johns Hopkins Bloomberg School of Public Health, UNITED STATES Received: January 21, 2014 Accepted: March 5, 2015 Published: April 17, 2015 Copyright: ?2015 Abuya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: The project is funded by the United States Agency for International Development under USAID Cooperative Agreement No. GHS-A-00-09-00015-00. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.Poor quality of care including fear of disrespect and abuse (D A) perpetuated by health workers influences women’s WP1066MedChemExpress WP1066 decisions to seek maternity care. Key manifestations of D A include: physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination, abandonment, and detention in facilities. This paper describes manifestations of D A experienced in Kenya and measures their prevalence.MethodsThis paper is based on baseline data collected during a before-and-after study designed to measure the effect of a package of interventions to reduce the prevalence of D A experienced by women during labor and delivery in thirteen Kenyan health facilities. Data were collected through an exit survey of 641 women discharged from postnatal wards. We present percentages of D A manifestations and odds ratios of its relationship with demographic characteristics using a multivariate fixed effects logistic regression model.ResultsTwenty percent of women reported any form of D A. Manifestations of D A includes: nonconfidential care (8.5 ), non-dignified care (18 ), neglect or abandonment (14.3 ), Nonconsensual care (4.3 ) physical abuse (4.2 ) and, detainment for non-payment of fees (8.1). Women aged 20-29 years were less likely to experience non-confidential care compared to those under 19; OR: [0.6 95 CI (0.36, 0.90); p=0.017]. Clients with no companion during delivery were less likely to experience inappropriate demands for payment; OR: [0.49 (0.26, 0.95); p=0.037]; while women with higher parities were three times more likely to be detained for lack of payment and five times more likely to be bribed compared to those experiencing there first birth.PLOS ONE | DOI:10.1371/journal.pone.0123606 April 17,1 /Disrespect and Abuse during Childbirth in KenyaConclusionOne out of five women experienced feeling humiliated during labor and delivery. Six categories of D A during childbirth in Kenya were reported. Understanding the prevalence of D A is critical in developing interventions at national, health FT011 structure facility and community levels to address the factors and drivers that influence D A in facilities and to encourage clients’ future facility utilization.BackgroundMultiple factors are impeding progress in attaining the fifth Millennium Development Goal of reducing maternal mortality and increasing universal access to reproductive health. These include inequities in financial and geographic access to quality services, health worker di.N ACCESS Citation: Abuya T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. (2015) Exploring the Prevalence of Disrespect and Abuse during Childbirth in Kenya. PLoS ONE 10(4): e0123606. doi:10.1371/ journal.pone.0123606 Academic Editor: David W. Dowdy, Johns Hopkins Bloomberg School of Public Health, UNITED STATES Received: January 21, 2014 Accepted: March 5, 2015 Published: April 17, 2015 Copyright: ?2015 Abuya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: The project is funded by the United States Agency for International Development under USAID Cooperative Agreement No. GHS-A-00-09-00015-00. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.Poor quality of care including fear of disrespect and abuse (D A) perpetuated by health workers influences women’s decisions to seek maternity care. Key manifestations of D A include: physical abuse, non-consented care, non-confidential care, non-dignified care, discrimination, abandonment, and detention in facilities. This paper describes manifestations of D A experienced in Kenya and measures their prevalence.MethodsThis paper is based on baseline data collected during a before-and-after study designed to measure the effect of a package of interventions to reduce the prevalence of D A experienced by women during labor and delivery in thirteen Kenyan health facilities. Data were collected through an exit survey of 641 women discharged from postnatal wards. We present percentages of D A manifestations and odds ratios of its relationship with demographic characteristics using a multivariate fixed effects logistic regression model.ResultsTwenty percent of women reported any form of D A. Manifestations of D A includes: nonconfidential care (8.5 ), non-dignified care (18 ), neglect or abandonment (14.3 ), Nonconsensual care (4.3 ) physical abuse (4.2 ) and, detainment for non-payment of fees (8.1). Women aged 20-29 years were less likely to experience non-confidential care compared to those under 19; OR: [0.6 95 CI (0.36, 0.90); p=0.017]. Clients with no companion during delivery were less likely to experience inappropriate demands for payment; OR: [0.49 (0.26, 0.95); p=0.037]; while women with higher parities were three times more likely to be detained for lack of payment and five times more likely to be bribed compared to those experiencing there first birth.PLOS ONE | DOI:10.1371/journal.pone.0123606 April 17,1 /Disrespect and Abuse during Childbirth in KenyaConclusionOne out of five women experienced feeling humiliated during labor and delivery. Six categories of D A during childbirth in Kenya were reported. Understanding the prevalence of D A is critical in developing interventions at national, health facility and community levels to address the factors and drivers that influence D A in facilities and to encourage clients’ future facility utilization.BackgroundMultiple factors are impeding progress in attaining the fifth Millennium Development Goal of reducing maternal mortality and increasing universal access to reproductive health. These include inequities in financial and geographic access to quality services, health worker di.