How health system failures and prevailing social norms drive mistreatment of women in maternity care in Ethiopia: a qualitative study.

Kasaye, H; Scarf, V; Sheehy, A; Baird, K

How health system failures and prevailing social norms drive mistreatment of women in maternity care in Ethiopia: a qualitative study.

Kasaye, H

Scarf, V

Sheehy, A

Baird, K

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Publisher:: TAYLOR & FRANCIS LTD
Publication Type:: Journal Article
Citation:: Glob Health Action, 2025, 18, (1), pp. 2526890
Issue Date:: 2025-12

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Field	Value	Language
dc.contributor.author	Kasaye, H https://orcid.org/0000-0003-3759-2604
dc.contributor.author	Scarf, V https://orcid.org/0000-0003-3503-9610
dc.contributor.author	Sheehy, A https://orcid.org/0000-0002-0037-1501
dc.contributor.author	Baird, K https://orcid.org/0000-0003-0142-6962
dc.date.accessioned	2025-08-06T04:32:32Z
dc.date.available	2025-08-06T04:32:32Z
dc.date.issued	2025-12
dc.identifier.citation	Glob Health Action, 2025, 18, (1), pp. 2526890
dc.identifier.issn	1654-9716
dc.identifier.issn	1654-9880
dc.identifier.uri	http://hdl.handle.net/10453/189267
dc.description.abstract	BACKGROUND: Mistreatment of women during maternity care is a widespread global issue, particularly in low- and middle-income countries where health disparities intersect with rigid gender norms, systemic inequality and domestic violence. OBJECTIVES: This paper aims to explore how health system failures and societal norms against women contribute to the mistreatment of women during maternity care. METHODS: A qualitative study was conducted among maternal healthcare providers in the East Wollega Zone, Ethiopia. In-depth interviews with purposively selected participants in Afan Oromo, each lasting 30-60 min, were conducted until data saturation was reached at 20 interviews. The interviews were audio-recorded, transcribed, translated into English, coded using NVivo 12 and analysed through thematic analysis guided by the Socioecological and Quality of Care frameworks. RESULTS: Health system conditions and constraints, such as under-resourcing and issues related to governance and providers' prejudices shaped by societal norms, were found to drive mistreatment of women during maternity care. These drivers manifest at various levels throughout the healthcare system, including personal, interpersonal, facility-level, health system and societal dimensions. Overcrowding, staff shortages and low pay led to burnout, which eventually resulted in mistreatment of women. The lack of recognition from administrators and professional hierarchies also added to provider frustration, which was sometimes directed at women. Societal issues, like gender-based violence, further influenced these behaviours. CONCLUSION: Mistreatment of women during maternity care continues to hinder the delivery of quality care. Addressing gender inequality, boosting healthcare worker motivation and ensuring fair treatment among staff are essential for promoting respectful maternity care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	TAYLOR & FRANCIS LTD
dc.relation.ispartof	Glob Health Action
dc.relation.isbasedon	10.1080/16549716.2025.2526890
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	4202 Epidemiology
dc.subject.classification	4206 Public health
dc.subject.mesh	Humans
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Social Norms
dc.subject.mesh	Adult
dc.subject.mesh	Pregnancy
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Health Personnel
dc.subject.mesh	Humans
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Pregnancy
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Adult
dc.subject.mesh	Health Personnel
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Social Norms
dc.subject.mesh	Humans
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Social Norms
dc.subject.mesh	Adult
dc.subject.mesh	Pregnancy
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Health Personnel
dc.title	How health system failures and prevailing social norms drive mistreatment of women in maternity care in Ethiopia: a qualitative study.
dc.type	Journal Article
utslib.citation.volume	18
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/School of Nursing and Midwifery
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/Women & Children’s Health Research Collaborative (WCHC)
pubs.organisational-group	University of Technology Sydney/UTS Groups/INSIGHT: Institute for Innovative Solutions for Wellbeing and Health
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2025-08-06T04:32:30Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	18
utslib.citation.issue	1

Abstract:

BACKGROUND: Mistreatment of women during maternity care is a widespread global issue, particularly in low- and middle-income countries where health disparities intersect with rigid gender norms, systemic inequality and domestic violence. OBJECTIVES: This paper aims to explore how health system failures and societal norms against women contribute to the mistreatment of women during maternity care. METHODS: A qualitative study was conducted among maternal healthcare providers in the East Wollega Zone, Ethiopia. In-depth interviews with purposively selected participants in Afan Oromo, each lasting 30-60 min, were conducted until data saturation was reached at 20 interviews. The interviews were audio-recorded, transcribed, translated into English, coded using NVivo 12 and analysed through thematic analysis guided by the Socioecological and Quality of Care frameworks. RESULTS: Health system conditions and constraints, such as under-resourcing and issues related to governance and providers' prejudices shaped by societal norms, were found to drive mistreatment of women during maternity care. These drivers manifest at various levels throughout the healthcare system, including personal, interpersonal, facility-level, health system and societal dimensions. Overcrowding, staff shortages and low pay led to burnout, which eventually resulted in mistreatment of women. The lack of recognition from administrators and professional hierarchies also added to provider frustration, which was sometimes directed at women. Societal issues, like gender-based violence, further influenced these behaviours. CONCLUSION: Mistreatment of women during maternity care continues to hinder the delivery of quality care. Addressing gender inequality, boosting healthcare worker motivation and ensuring fair treatment among staff are essential for promoting respectful maternity care.

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http://hdl.handle.net/10453/189267