Acceptability and Satisfaction of Birth Companionship Among Health Providers and Clients in Rural Public Health Facilities in Kigoma, Western Tanzania
Introduction: Birth Companionship, including continuous emotional and social support during childbirth, improves maternal and newborn health outcomes and women's satisfaction with care. Birth companionship has not been systematically introduced in government health facilities in Tanzania. To learn about feasibility, acceptability of companionship at birth and if it contributes to improved quality of care, Thamini Uhai implemented a pilot project in nine public facilities in Kigoma and six control sites.
Methods: The project was implemented from July 2018 to December 2018. Women delivering at intervention sites were given the choice of having a birth companion during childbirth. We evaluated the project using routine utilization data, focused group discussions, and structured and semi-structured interviews. We compared selected elements in providers and client experience and satisfaction between nine intervention and six control sites during the same period.
Results: At intervention sites, over 80% of women delivering had a birth companion who supported them during childbirth by comforting women and staying by their side. Most women reported the presence of a companion improved their labor, delivery, and postpartum experience (82–97%). Health providers found companions very helpful as they assisted with their workload, alerted the provider about changes in the woman's status, and provided emotional support. When comparing intervention and comparison sites, health providers at intervention sites were significantly more likely to: respond to women who called for help (p=0.003), interact in a friendly way (p<0.001), greet women respectfully (p<0.001), and try to make them more comfortable (p=0.003). Higher proportions of women who gave birth at intervention sites reported being "very satisfied" with the care they received (p<0.001) and that the staff was "very kind" (p<0.001) and "very encouraging" (p<0.001).
Conclusion: Birth companionship was feasible and well accepted by health providers and women who delivered at intervention facilities. The introduction of birth companionship improved both women's satisfaction and experience of childbirth.
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