FROM PROTOCOL TO MEASUREMENT: PILOTING A CULTURALLY ADAPTED RESPECTFUL MATERNITY CARE INSTRUMENT IN TRIBAL ODISHA, INDIA

Abstract

Background: Respectful maternity care (RMC) is crucial for quality maternal services, particularly in diverse settings. This study assesses healthcare professionals' knowledge, attitude, practice, and perceived barriers (KAP-B) regarding RMC, focusing on nurses' roles, in the sole First Referral Unit (FRU) in the Particularly Vulnerable Tribal Group (PVTG) predominant Gajapati district of Odisha, India. Objectives: This study aimed to: (1) Quantify RMC training gaps and protocol adherence among healthcare providers; (2) Compare RMC implementation between nurses and doctors; (3) identify cultural and systemic barriers; and (4) propose context-specific interventions for PVTG-dominated districts.

Methods: A cross-sectional study was conducted using a structured questionnaire administered to all 12 healthcare providers (9 nurses and 3 specialist doctors) engaged at the Maternity wing of the District Headquarters Hospital. Data were analyzed using descriptive statistics, nonparametric tests, and chi-square tests.

Results: Only 25% of respondents had received formal RMC training. All respondents believed in RMC's importance for outcomes. About 67% disagreed that cultural differences influenced RMC provision, while language and beliefs were barriers. Majority indicated frequent adherence to RMC protocols, with no difference between nurses and doctors. Major challenges included inadequate resources and poor communication, with nurses affected by workloads.

Conclusion: Nurses, vital to respectful maternity care (RMC), face hurdles despite acknowledging its value. Context-specific solutions and cultural training enhance RMC quality in tribal regions. Overcoming resource limitations and improving nurses' cross-cultural skills are crucial for maternal care in tribal regions. These challenges require strategies to ensure effective RMC implementation across healthcare settings.