ArticleBMJ global health2021
Development of measures for assessing mistreatment of women during facility-based childbirth based on labour observations.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05110521 (Impact of a Nurse Mentorship and Digital Health Package Intervention for Maternal and Newborn Health in Kenya), which is not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of a Nurse Mentorship and Digital Health Package Intervention for Maternal and Newborn Health in Kenya: A Cluster Randomized Controlled Trial
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Women's reported experience of respectful maternity care measures worldwide: a systematic review.BMC public health · 2026Pooled it
- Methods to derive composite indicators used for quality and safety measurement and monitoring in healthcare: a scoping review.Frontiers in health services · 2026Pooled it
- A Scoping Review of Available Scales and Tools Used to Measure Obstetric Violence.Journal of advanced nursing · 2026Article
- Mistreatment of women during childbirth and its determinants: a cross-sectional study in Mazandaran/Iran.BMJ open · 2026Article
- Dimensional structure and internal consistency of the Brazilian Portuguese version of the Mistreatment of Women during Childbirth Questionnaire.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Article
- Impact of a long-term mentorship program for childbirth providers on quality of care: A cluster randomized controlled trial.PLOS global public health · 2026Article
- Labour companionship and respectful treatment of women during childbirth: a cross-sectional study across 16 hospitals in Benin, Malawi, Tanzania and Uganda.BMJ public health · 2025Article
- The assessment of psychometric properties of childbirth violence questionnaire in Iranian women.PloS one · 2025Article
- A multilevel developmental psychopathology model of childbirth and the perinatal transition.Development and psychopathology · 2024Review
- Comparing observed occurrence of mistreatment during childbirth with women's self-report: a validation study in Ghana, Guinea and Nigeria.BMJ global health · 2023Article
- Dignity and respect in maternity care.BMJ global health · 2022Article
- Women's report of mistreatment during facility-based childbirth: validity and reliability of community survey measures.BMJ global health · 2021Article
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Corrections and comments
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Authors and funding
10 authors at 8 institutions in 7 countries.
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Abstract
introductionMistreatment of women during childbirth is increasingly recognised as a significant issue globally. Research and programmatic efforts targeting this phenomenon have been limited by a lack of validated measurement tools. This study aimed to develop a set of concise, valid and reliable multidimensional measures for mistreatment using labour observations applicable across multiple settings.
methodsData from continuous labour observations of 1974 women in Nigeria (n=407), Ghana (n=912) and Guinea (n=655) were used from the cross-sectional WHO's multicountry study 'How women are treated during facility-based childbirth' (2016-2018). Exploratory factor analysis was conducted to develop a scale measuring interpersonal abuse. Two indexes were developed through a modified Organisation for Economic Co-operation and Development approach for generating composite indexes. Measures were evaluated for performance, validity and internal reliability.
resultsThree mistreatment measures were developed: a 7-item Interpersonal Abuse Scale, a 3-item Exams & Procedures Index and a 12-item Unsupportive Birth Environment Index. Factor analysis results showed a consistent unidimensional factor structure for the Interpersonal Abuse Scale in all three countries based on factor loadings and interitem correlations, indicating good structural construct validity. The scale had a reliability coefficient of 0.71 in Nigeria and approached 0.60 in Ghana and Guinea. Low correlations (Spearman correlation range: -0.06-0.19; p≥0.05) between mistreatment measures supported our decision to develop three separate measures. Predictive criterion validation yielded mixed results across countries. Both items within measures and measure scores were internally consistent across countries; each item co-occurred with other items in a measure, and scores consistently distinguished between 'high' and 'low' mistreatment levels.
conclusionThe set of concise, comprehensive multidimensional measures of mistreatment can be used in future research and quality improvement initiatives targeting mistreatment to quantify burden, identify risk factors and determine its impact on health and well-being outcomes. Further validation and reliability testing of the measures in other contexts is needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.