Respectful Maternity Care and Its Associated Factors at Kitale County Referral Hospital, Trans Nzoia County, Kenya

Context: Respectful maternity care (RMC) comprises the seven elements as enlisted by the World Health Organization, including harm-free care, consensual care, confidentiality, dignity, non-detention, non-abandonment, and care without discrimination, which ensures that a pregnant mother is accorded respect whenever they seek maternal services at health facilities during pregnancy, labor, delivery and postnatal period. Various factors play a role in respectful maternity care, including maternal factors, singular health provider factors, health system factors, and other systemic factors. These factors have been known to play a critical role when a mother seeks care in a health facility, even determining the kind of care the mother will be offered. Aim: The study aimed to evaluate respectful maternity care and its associated factors at Kitale County Referral Hospital in Trans Nzoia County, Kenya. Methods: Institutional-based cross-sectional study design was used. Data was collected using pre-tested questionnaires among mothers (n=260) who had delivered and were in the postnatal ward at Kitale County Referral Hospital, Trans Nzoia County, Kenya. Results: Most (83.5%) mothers were accorded respectful maternity care while in the health facility. The following factors were significantly associated with respectful maternity care; marital status: Married [OR=1.51 (95% CI: 0.46-2.33), p=0.002], residence: Urban [OR=1.46 (95% CI: 0.35-3.01), p=0.025], employment type: Housewife [OR=1.83 (95% CI: 1.61-3.26), p=0.001], parity: Three [OR=1.74 (95% CI: 0.27-3.28), p=0.001], place of last delivery: Hospital [OR=2.01 (95% CI: 1.51-2.45), p=0.016], mode of delivery: Spontaneous vertex delivery [OR=1.13 (95% CI: 0.24-3.28), p=0.018], occurrence of complication after delivery: Yes [OR=2.17 (95% CI: 0.25-1.26), p=0.001], waiting time: Less than half an hour [OR=2.1 (95% CI: 1.32-3.21), p=0.003], waiting time was okay: Yes [OR=1.1 (95% CI: 1.46-3.68), p=0.018], number of health providers assisting a delivery: Two [OR=1.56 (95% CI: 0.45-1.31), p=0.041], intention to deliver in the facility later: Yes [OR=0.7 (95% CI: 1.36-2.19), p=0.002], and recommending others to deliver in the facility: Yes [OR=0.71 (95% CI: 0.21-1.34), p=0.039]. Conclusion: Most respondents reported respectful maternity care at Kitale County Referral Hospital. Factors such as marital status, place of residence, employment status, parity, previous birthplace, mode of delivery, occurrence of a complication, waiting time, being okay with the time, number of health providers assisting a delivery, intention to use the facility and recommending others to use the facility were significantly associated with respectful maternity care. The study recommends that the county department of health develops an education program so that all pregnant mothers are empowered on respectful maternity care when they seek antenatal services before they come to deliver in health facilities. Further, the hospital management ensures pregnant mothers' privacy in the maternity unit.