Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality.

Background: The mistreatment and abuse of women during childbirth have been recognized as a major global health challenge, impeding facility-based delivery and contributing to the high maternal mortalities globally. The World Health Organization has specifically called for interventions to deal with obstetric violence. This scoping review consolidates the existing literature on interventions aimed at reducing obstetric violence and synthesizes existing knowledge on their impact in promoting respectful maternity care. Methodology: Thirteen electronic databases were searched for relevant articles from January 2001 to March 2023. A total of 863 records were identified, and 72 full-text articles were retrieved for further screening. The review includes 16 studies, particularly from low- and middle-income countries, with interventions implemented at medical facilities and involving both women and healthcare providers. Eight of the studies were quantitative, three were qualitative and five used a mixed-methods approach. Findings: The results reveal a promising trend in reducing obstetric violence through various interventions. Ten different types of interventions were identified, highlighting strategies to improve the quality of maternity care and enhance patient-centered care. Improved patient-provider communication skills, increased privacy measures, and reduced abuse and mistreatment emerged as common themes. Enhanced communication skills, including open discussions and the right to be informed, were crucial in reducing obstetric violence. Privacy measures, such as separate rooms, curtains, and birth companions effectively decreased incidents of non-confidential care. General abuse and mistreatment, including physical abuse and neglect, were also reduced, leading to improved perceptions of respectful care during childbirth. Conclusion: Overall, the interventions had a favorable impact on obstetric violence reduction and women's childbirth experiences. However, despite promising results, obstetric violence remains prevalent worldwide, necessitating more efforts to implement effective interventions. To the best of our knowledge, this is the first scoping review on obstetric violence interventions, providing a comprehensive overview of the state of the art. We suggest that further research is needed to explore new interventions, particularly gender-sensitive interventions, to contribute to a growing body of knowledge on the prevention of obstetric violence.

Did Ghana Do Enough? A Scientometric Analysis of COVID-19 Research Output from Ghana within the African Context.

The COVID-19 pandemic has generated worldwide research efforts to provide knowledge about the disease. Yet little is known about how Ghana contributed to this critical knowledge production. This scientometric analysis was conducted to ascertain Ghana's COVID-19 research output within the African context to gain understanding and identify potential future directions. The study retrieved relevant research, spanning 2019 to 2022, from the Scopus database in December 2022. The retrieved data were assessed using various established indices, including collaboration patterns, productive institutions, citation patterns, and major research sponsors, among others. Ghana came seventh in Africa with a total of 1112 publications. For international collaborations, the United States and the United Kingdom were the major partners, while South Africa was the main African collaborator with Ghana. Out of the top 21 most productive authors, 85.7% were males and 14.3% were females, demonstrating a great gender gap in research output in Ghana. Although Ghana has made some contributions to the global COVID-19 research output, there are few intra-continental research collaborations, which limits Africa's overall research output. Our study demonstrates a critical need for the Ghanaian government to prioritize research and funding and address barriers to women's research productivity.

Abuse and humiliation in the delivery room: Prevalence and associated factors of obstetric violence in Ghana.

Background: Abuse and mistreatment of women during childbirth is a major barrier to facility-based delivery, putting women at risk of avoidable complications, trauma and negative health outcomes including death. We study the prevalence of obstetric violence (OV) and its associated factors in the Ashanti and Western Regions of Ghana. Methodology: A facility-based cross-sectional survey was conducted in eight public health facilities from September to December 2021. Specifically, close-ended questionnaires were administered to 1,854 women, aged 15-45 who gave birth in the health facilities. The data collected include the sociodemographic attributes of women, their obstetric history and experiences of OV based on the seven typologies according to the categorization by Bowser and Hills. Findings: We find that about two in every three women (65.3%) experience OV. The most common form of OV is non-confidential care (35.8%), followed by abandoned care (33.4%), non-dignified care (28.5%) and physical abuse (27.4%). Furthermore, 7.7% of women were detained in health facilities for their inability to pay their bills, 7.5% received non-consented care while 11.0% reported discriminated care. A test for associated factors of OV yielded few results. Single women (OR 1.6, 95% CI 1.2-2.2) and women who reported birth complications (OR 3.2, 95% CI 2.4-4.3) were more likely to experience OV compared with married women and women who had no birth complications. In addition, teenage mothers (OR 2.6, 95% CI 1.5-4.5) were more likely to experience physical abuse compared to older mothers. Rural vs. urban location, employment status, gender of birth attendant, type of delivery, time of delivery, the ethnicity of the mothers and their social class were all not statistically significant. Conclusion: The prevalence of OV in the Ashanti and Western Regions was high and only few variables were strongly associated with OV, suggesting that all women are at risk of abuse. Interventions should aim at promoting alternative birth strategies devoid of violence and changing the organizational culture of violence embedded in the obstetric care in Ghana.

Prevalence of Hepatitis B Virus Infection among Inmates at the Monrovia Central Prison, Liberia.

Determination of hepatitis B virus (HBV) infections in key populations including prison inmates is crucial for formulating appropriate intervention approaches. However, in many low-income countries, such as Liberia, there is hardly any documentation on HBV prevalence among inmates. This study determined and evaluated the prevalence of HBV infections among incarcerated persons in the Monrovia Central Prison, Liberia. One hundred participants comprising 76 males and 24 females were studied. Participants' demographic and potential risk factors information were obtained using a semi-structured questionnaire, and blood samples were collected for the analysis. Plasma was tested for five HBV serological markers, namely, HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb. The seroreactivity of actively infected persons was confirmed by nucleic acid detection. Results of the serological assay showed that 34% of the participants had been exposed to the virus and 14% were actively infected. qPCR confirmed HBV DNA in seven actively infected samples. Statistical analysis indicated that a low level of education, a history of blood transfusion, and intravenous drug use, were significant predictors of active HBV infection and HBV exposure, respectively. These findings might make the testing and vaccination of convicts against HBV infection prior to their admission into prison facilities imperative.