An average of 72% of users of the National Health System in Mozambique are unaware of the existence of obstetric violence. It means that most of the Mozambican people is not aware of this bad practice, which has been victimizing women in maternity services.
This finding can be observed in the most recent study carried out by the Citizen Observatory for Health (OCS), in partnership with Saber Nascer. The research, which was developed within the framework of the Sou Cidadão Project, funded by the European Union, through PAANE, is focused on evaluating the situation of Obstetric Violence in Mozambican Health Units.
According to the survey data, the province of Tete, with 42%, has the highest rates of mistreatment in the prenatal period, childbirth and the service of weight control of the child. Next comes Inhambane Province, Sofala and Maputo Province, with 38%, 36% and 17%, respectively.
Disaggregating the data, it was found that 36.2% of women in Sofala Province had already suffered abuse, compared to 63.8% who said that they had never suffered abuse in the health unites. Although the number of women who have not suffered abuse is higher compared to the number of women who have suffered abuse, there is a lack of empathy and humanism in health services throughout the country.
In turn, insults occupy the second place in violence suffered by women in obstetric services and in the Mother-Child Service (MCH) with 19.3% of complaints registered; illegal charges in the order of 6.3%; refusal in attendance in 1.9% and, finally, violence in the order of 1.0%.
The study also points out that about 71.5% of users, in this province, did not have access to information, which constitutes one of the most serious violations of the rights of the patient, recognized by the Charter of Rights and Duties of the Patient (CDDD), approved by Resolution 73/2007 of December 18, 2007.
On the other hand, in Inhambane Province, 37.5% of the women said that they had already suffered mistreatment against 62.5% who said that they had never experienced mistreatment in the Health Units. Insults, on the order of 36.2%, constitute the most recurrent form of mistreatment.
Refusal of attendance is in the order of 12.9%, and illegal charges and lack of information are in the order of 7.1%. Finally, physical violence is in the order of 1.8%, which points to the dehumanization inside the health units.
In Tete province, the highlight goes to physical violence and illicit charges that stand out in the list of mistreatments, in addition to the refusal of attendance.
Compared to other provinces, Maputo shows 79% of women who say they have never heard of Obstetric Violence, against 21% who have heard about the phenomenon.
Comparing the data collected in each region, it is observed that Maputo presents few critical cases because it has several organizations that work in the health field, taking into account that one of the organizations that works against Obstetric is this city.
Despite the fact that the country’s capital offers greater coverage and availability of health infrastructure, 39% of women say that they would not return to public health services, against 61% who said they would return to use public health services. In this case, it can be seen that, in contrast to other provinces, the percentage of women who would not return to public services is significant.
In this study, it is presented the following recommendations:
- Hold lectures, campaigns, and cultural activities to raise awareness about Obstetric Violence;
- Disseminate the rights and duties of pregnant women, through lectures, virtual and face-to-face workshops, involving the communities, as well as dissemination on community radios, televisions, and at health fairs;
- Monitor the health units to understand the level of knowledge of women and health professionals about Obstetric Violence;
- Train health professionals on a quarterly basis about good practices of obstetric humanization.
The field research took place from April to May 2022, in the following provinces: Maputo, Inhambane, Sofala and Tete, covering 13 Health Units.