Childbirth experiences among women living with HIV in Kilimanjaro, Tanzania:A mixed method study on respectful maternity care

Abstract Background This mixed-method study explored the experiences of respectful maternity care (RMC) during childbirth among women living with HIV (WLHIV) in Tanzania. Method We recruited 103 WLHIV from six healthcare facilities within 48 hours of giving birth. Participants completed a survey using audio computer-assisted self-interview survey technology. In-depth interviews were conducted with 12 pregnant WLHIV and 12 postpartum WLHIV. Findings In the survey reports from RMC were overall positive. The median score on the full RMC scale (possible range: 0-100) was 74.4, with the highest scores in the subscale of dignity and respect (83.3), followed by supportive care (77.8) and communication and autonomy (62.9). Qualitative data suggest a general appreciation of care received, but some participants reported that providers neglected them, avoided physical contact, or did not seek their consent for procedures. In addition, they reported issues of overcrowding, long waiting times for care services, and restrictions on birth companions. Discussion This data suggests there is an opportunity for additional provider training in clinical empathy and patient-centered practices to address the unique needs of WLHIV and enhance their overall maternity care satisfaction and health outcomes.