Assessment of the Level of Knowledge of Respectful Maternity Care and Sexual and Reproductive Health and Rights in South Sudan

Agnes Juan Silver¹, Grace Nimir Benjamin², Kariane St-Denis³ and Ferdinand Nsengimana^4,

¹Executive Director, South Sudan Nurses and Midwives Association (SSNAMA), Juba, South Sudan

²Program Coordinator, South Sudan Nurses and Midwives Association (SSNAMA), Juba, South Sudan

³Project Officer, Global Programs, Canadian Association of Midwives (CAM), Montreal, Canada

⁴Consultant Researcher, Canadian Association of Midwives (CAM), Muyinga, Burundi

Cite this paper:
Agnes Juan Silver, Grace Nimir Benjamin, Kariane St-Denis and Ferdinand Nsengimana. Assessment of the Level of Knowledge of Respectful Maternity Care and Sexual and Reproductive Health and Rights in South Sudan. American Journal of Public Health Research. 2023; 11(6):197-205. doi: 10.12691/ajphr-11-6-4

Abstract

Background: Despite a noticeable decrease over the past ten years, South Sudan still ranks among the countries with the highest maternal and neonatal mortality ratios in the world. The provision of a care that is more client-centered and culturally sensitive, such as Respectful Maternity Care (RMC) in a Sexual and Reproductive Health and Rights (SRHR) enabling environment, is key to reducing maternal and neonatal mortality. Nevertheless, health care providers’ and consumers’ perceptions, awareness and level of knowledge may influence the uptake and potential impact of RMC. Objectives: To assess 1) the level of understanding of RMC and related clinical practices among health care providers, as well as gaps in knowledge and skills for the uptake of RMC at targeted health facilities in the project regions (“What midwives want”); 2) the level of understanding of RMC and SRHR among women of reproductive age (including adolescent girls and women with disabilities), as well as women’s current experiences of care, unmet needs, and preferences at targeted health facilities in the project regions (“What women want”); and 3) the level of understanding of RMC and SRHR among key stakeholders (health facility administrators, male community members, youth representatives) as well as their views and perceptions of women’s SRHR in targeted communities within the project regions. Methods: Using mixed methods, data were collected from health facilities in six states in South Sudan. Quantitative data were analyzed using Microsoft Excel 2010. Some qualitative data were analyzed by grouping them according to the domains of RMC or the domains of SRHR as based on the established literature, while other qualitative data were analyzed by coding and identifying categories and themes within the data. Results: Only 5% of key stakeholders and <1% of women of reproductive age correctly listed three examples of SRHR. Seventy percent of key stakeholders reported that RMC was a commonly used terminology. However, more health care providers than women of reproductive age had heard about RMC either occasionally or often, while more women of reproductive age (43%) than health care providers (8%) had never heard about RMC. When asked to identify key elements of RMC, 53% of health care providers compared to 45% of key stakeholders and 31% of women of reproductive age gave an answer that aligned with one or more of the 12 domains of RMC. The most cited type of support that health care providers required in order to provide RMC was both general and RMC-focused capacity building, followed by increased salaries and other forms of motivation as well as ensuring supplies and equipment are made available. The proportion of women of reproductive age who reported sometimes or never receiving RMC was generally higher than the proportion of health care providers who reported sometimes or never rendering RMC, suggesting a misalignment between the perceptions or reporting practices of these two groups. Similarly, more women of reproductive age reported incidents of mistreatment than did the health care providers. Conclusion: There is a limited understanding of RMC and SRHR among health care providers, key stakeholders, and women of reproductive age. It is recommended that the Ministry of Health, together with implementing partners, organize and conduct RMC and SRHR awareness activities that target service providers, service consumers, and key stakeholders in order to sensitize them to the rights of childbearing women and newborns.

Keywords:
respectful maternity care sexual and reproductive health and rights maternal health health care providers midwifery women of reproductive age

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