Evidence map›Paper›PMID 40119260›Full record

ArticleBMC pregnancy and childbirth2025

Measuring responsiveness and respectful treatment in maternity care in sub-Saharan Africa: a questionnaire validation and development of a score.

Zoë Morris, Soha El Halabi, Claudia Hanson, Bianca Kandeya, Elizabeth Ayebare, Gisele Houngbo, Anastasia Månsson, Fadhlun Alwy Al-Beity, Kristi Sidney Annerstedt

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Zoë MorrisDepartment of Global Public Health, Karolinska Institutet, Solna, Sweden.
Soha El HalabiDepartment of Global Public Health, Karolinska Institutet, Solna, Sweden.
Claudia HansonDepartment of Global Public Health, Karolinska Institutet, Solna, Sweden.
Bianca KandeyaKamuzu University of Health Sciences- Centre for Reproductive Health, Blantyre, Malawi.
Elizabeth AyebareCentre of Excellence for Maternal Newborn and Child Health, Department of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.
Gisele HoungboCentre de Recherche en Reproduction Humaine et en Démographie (CERRHUD), Benin College of Medicine, Cotonou, Benin.
Anastasia MånssonDepartment of Global Public Health, Karolinska Institutet, Solna, Sweden.
Fadhlun Alwy Al-Beity *Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
Kristi Sidney Annerstedt *Department of Global Public Health, Karolinska Institutet, Solna, Sweden. kristi.sidney@ki.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe importance of respectful maternity care on optimal maternal outcomes is increasingly acknowledged globally. However, mistreatment and abuse are still experienced by women during hospital childbirth in many parts of the world, with sub-Saharan Africa being one of the places where it is most common. Interventions aiming to improve respectful maternity care must be able to assess the prevalence of responsiveness and mistreatment women experience. This is usually done with questionnaires, though these are not always validated. Scores to represent the level of responsiveness and mistreatment experienced can be created from questionnaire results and have many uses, though no score is consistently used in this field. A new questionnaire measuring responsiveness and respectful treatment was developed for use in the ALERT project, as a questionnaire covering both of these concepts did not exist. This study aimed to validate this questionnaire and to create a scoring method.

methodsPsychometric analyses, including exploratory and confirmatory factor analysis, were performed on cross-sectional data collected from the ALERT study to identify and confirm underlying factors. Using these factors, simple summation and factor-weighted methods were used to create scores and their results compared.

resultsSix factors were identified: "Communication & supportive care", "Hospital environment", "Maintained respect & dignity", "Social support", "Maintained privacy & confidentiality" and "Lack of physical & verbal abuse". The results of the two scoring methods developed were similar.

conclusionsThe responsiveness and respectful treatment questionnaire has high validity in the ALERT study population for the six factors identified. The two scoring methods developed are useful for different aspects of the ALERT intervention and can be used to facilitate comparisons or measure progress towards improving respectful maternity care in these settings.

Indexed as

Maternal Health ServicesRespectAdultAfrica South of the SaharaCross-Sectional StudiesDelivery, ObstetricFactor Analysis, StatisticalFemaleHumansPregnancyProfessional-Patient RelationsPsychometricsReproducibility of ResultsSocial SupportSurveys and QuestionnairesFactor analysisPerson-centered carePsychometric analysisRespectful maternity careScale scoreSub-Saharan AfricaValidation

Identifiers

PMID40119260
PMCPMC11927248

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.