Govender, Veloshnee, Topp, Steph, and Tuncalp, Ozge (2022) Rethinking trust in the context of mistreatment of women during childbirth: a neglected focus. BMJ Global Health, 7 (5). e009490.

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Abstract

[Extract] The mistreatment of women during childbirth is a global phenomenon.1 Mistreatment includes physical and verbal abuse, violations of privacy, stigma and discrimination, and neglect and abandonment. To date, much of the focus has been on measuring this phenomenon and the interpersonal relationships between women and health workers and the role of and abuse of power by these workers.2 However, more recently, there have been increasing calls for widening the lens on underlying drivers of mistreatment of women during childbirth to include the considerations of social, gender and economic inequalities,3 and systemic failures both at health facility and the health system levels.1 4 5

This recognition and renewed attention on the wider social, economic and political systems in which health systems are embedded is important for two reasons. First, while much of the mistreatment is often carried out by health workers and especially those at the frontline, it is important to recognise that many of these health workers are located lower in the organisational hierarchy, themselves overworked and abused in under-resourced and poorly supervised environments and overall dysfunctional health systems.6–9 This recognition has underpinned nascent investigation of the role of workplace and institutional trust in some settings.10–13

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