article · BMJ Global Health
Maternal care experiences during childbirth are central to global health goals, yet comparisons between mothers with and without HIV remain under-researched. A cross-sectional study in Mbeya, Tanzania, evaluated childbirth experiences one week postpartum using Swahili translations of the Childbirth Experience Questionnaire and the Birth Satisfaction Scale-Revised. Among 626 surveyed mothers, nearly half were living with HIV. Mothers with HIV consistently reported poorer outcomes across multiple domains of both assessment tools compared to uninfected peers. Even after adjusting for demographic factors, women without HIV scored significantly higher in measures of professional support, own capacity, participation, and quality of care provision. The findings demonstrate a distinct disparity in maternal care experiences, highlighting an urgent operational need to advance respectful maternity care interventions tailored to mothers living with HIV.
Evaluating patient experience is essential for improving healthcare standards and achieving Sustainable Development Goals. By identifying that mothers living with HIV receive poorer perinatal care and professional support during childbirth, healthcare systems can address specific inequities and design targeted clinical guidelines to ensure respectful, dignified care for vulnerable mothers.
The translated Swahili versions of the assessment tools offer an applied framework that hospital administrators, healthcare providers, and public health organisations can use to audit maternal care quality. This applied research informs clinical training programmes and operational quality monitoring tools, though the abstract does not indicate a direct pathway towards commercial products or proprietary technology.
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INTRODUCTION: Mothers' experiences at birth and respectful maternal care are critical to achieving Sustainable Development Goal number 3 in Tanzania. However, little is known about the differences in perinatal experience quality between women with and without HIV. To address this gap, we compared mothers' experience at birth among women with and without HIV. METHODS: This cross-sectional study was conducted in four Reproductive and Child Health Clinics in Mbeya, Tanzania between June and August 2022. Childbirth experience was assessed among mothers with and without HIV 1 week after birth using the Child Birth Experience Questionnaire (CEQ) and Birth Satisfaction Scale-Revised (BSS-R) questionnaires translated to Swahili. Higher scores reflected better experiences. Using this baseline assessment, bivariate and multivariate linear regression analyses tested the associations between HIV status and other patient factors and child-birth experience scores. RESULTS: A total of 1252 mothers were invited, of which 626 (288 (46%) with HIV, mean (SD age 31.9±7.8 years)), were included. Mothers with HIV had lower scores in most CEQ and BSS-R domains compared with mothers without HIV. Significant mean CEQ score differences between mothers with and without HIV were observed in both CEQ and BSS-R scores: After adjusting for demographic factors, regression coefficients, β for CEQ scores were higher among mothers without HIV compared with mothers with HIV for: 'own capacity' 0.73, p<0.001, 'Professional support' 0.94, p<0.001 and 'Participation' 0.33, p<0.001. Similarly, β for BSS-R scores were higher among mothers without HIV for 'Quality of care provision' 0.87, p<0.001), 'Women's personal attributes' 0.27, p=0.002 and 'Stress experienced' 0.1, p=0.1. CONCLUSIONS: Mothers with HIV in the postpartum period reported poorer CEQ and BSS-R scores compared with mothers without HIV. These results suggest a need to improve respectful maternity care at birth among the mothers with HIV.
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DOI: 10.1136/bmjgh-2024-016745
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