ArticleBMJ open2020
Pre-post implementation survey of a multicomponent intervention to improve informed consent for caesarean section in Southern Malawi.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Incidence, management and outcomes of prolonged second stage of labour in a rural setting in Malawi: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Evaluation of the surgical informed consent for elective and emergency surgeries in obstetrics and gynaecology in Saudi Arabia.BMC medical ethics · 2025Article
- Content and design of respectful maternity care training packages for health workers in sub-Saharan Africa: Scoping review.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Association between delayed cesarean section and severe maternal and adverse newborn outcomes in the Somaliland context: a cohort study in a national referral hospital.Global health action · 2023Article
- Implementing maternal and newborn health quality of care standards in healthcare facilities to improve the adoption of respectful maternity care in Bangladesh, Ghana and Tanzania: a controlled before and after study.BMJ global health · 2023Article
- Surgical Informed Consent in Clinical Practice: Patients' Perspective Undergoing Cesarean Section at Three Teaching Hospitals in Addis Ababa, Ethiopia.Ethiopian journal of health sciences · 2023Article
- The Case for Using a Behavior Change Model to Design Interventions to Promote Respectful Maternal Care.Global health, science and practice · 2023Article
- Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis.PLOS global public health · 2023Article
- The Quality of Informed Consent in Caesarean Section at a Tertiary Hospital in Addis Ababa, Ethiopia.International journal of women's health · 2022Article
- Health workers' perspectives on informed consent for caesarean section in Southern Malawi.BMC medical ethics · 2021Article
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveSurgical informed consent is essential prior to caesarean section, but potentially compromised by insufficient communication. We assessed the association between a multicomponent intervention and women's recollection of information pertaining to informed consent for caesarean section in a low-resource setting, thereby contributing to respectful maternity care.
designPre-post implementation survey, conducted from January to June 2018, surveying women prior to discharge.
settingRural 150-bed mission hospital in Southern Malawi.
participantsA total of 160 postoperative women were included: 80 preimplementation and 80 postimplementation.
interventionBased on observed deficiencies and input from local stakeholders, a multicomponent intervention was developed, consisting of a standardised checklist, wall poster with a six-step guide and on-the-job communication training for health workers. PRIMARY AND SECONDARY OUTCOME MEASURES: Individual components of informed consent were: indication, explanation of procedure, common complications, implications for future pregnancies and verbal enquiry of consent, which were compared preintervention and postintervention using χ
resultsThe proportion of women who recollected being informed about procedure-related risks increased from 25/80 to 47/80 (OR 3.13 (95% CI 1.64 to 6.00)). Recollection of an explanation of the procedure changed from 44/80 to 55/80 (OR 1.80 (0.94 to 3.44)), implications for future pregnancy from 25/80 to 47/80 (1.69 (0.89 to 3.20)) and of consent enquiry from 67/80 to 73/80 (OR 2.02 (0.73 to 5.37)). After controlling for other variables, incompleteness scores postintervention were 26% lower (Exp(β)=0.74; 95% CI 0.57 to 0.96). Recollection of common complications increased with 0.25 complications (β=0.25; 95% CI 0.01 to 0.49). Recollection of the correct indication did not differ significantly.
conclusionRecollection of informed consent for caesarean section changed significantly in the postintervention group. Obtaining informed consent for caesarean section is one of the essential components of respectful maternity care.
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