Midwifery and nursing students’ perceptions of respectful maternity care and witnessing of disrespect and abuse: A comparative study from Nepal and Jordan

Prativa Dhakal, Khitam Ibrahem Mohammad, Debra K. Creedy, Jennifer Gamble, Elizabeth Newnham, Rhona McInnes

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Objectives: To compare Nepalese and Jordanian midwifery and nursing students’ perceptions of respectful maternity care (RMC) and witnessing of disrespect and abuse; and determine factors that predict scores on a scale measuring perceptions of RMC. Design: A descriptive, comparative design was used. Setting: Recruitment took place from two medical colleges in Nepal and one University in Jordan. Methods: A convenience sample of students (n = 276) enrolled in a Bachelor or Diploma level midwifery or nursing degree who were undertaking or had recently completed their midwifery clinical placement were recruited. The online or hard copy survey included the Students’ Perceptions of Respectful Maternity Care (SPRMC) Scale and nine questions on witnessing different types of disrespect and abuse. Findings: Nepalese students were slightly older (mean = 23.68 years) than Jordanian students (mean = 21.36). Mean duration of clinical placement was longer for Jordanian students (11.24 compared to 6.28 weeks). However, mean number of births observed was higher among Nepalese students (19.6 compared to 18.62). Overall, perceptions of RMC were more positive among Jordanian students (t (199.97) = 6.68, p < 0.001). A multiple regression analysis found that duration of clinical placement (beta = 0.22, p < 0.001), witnessing disrespect and abuse (beta = 0.11, p = 0.08) and age (beta = -0.14, p = 0.03) explained 12.2% of variance in SPMRC scores. Compared to students in Nepal, all Jordanian students had observed non-consented care during their clinical practicum. However, Nepalese students were more likely to observe poor adherence to women's privacy and confidentiality. Key conclusion and implications for practice: This is the first study to compare midwifery and nursing students’ perceptions of RMC across two middle-income countries. Although Jordanian students held more positive perceptions of RMC than those in Nepal, more had witnessed different forms of disrespect and abuse. Variations in students’ perceptions of RMC and witnessing of abuse across countries highlight the need for assessment of workplace cultures to inform the development of tailored education and practice interventions for students, clinicians, and managers. Future research needs to explore how to best support students to consistently offer RMC and how to improve the experiences of childbearing women.

Original languageEnglish
Article number103426
Number of pages7
Early online date7 Jul 2022
Publication statusPublished - 1 Sept 2022

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© 2022, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

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  • Abuse
  • Disrespect
  • Middle-income countries
  • Midwifery
  • Nursing
  • Perceptions
  • Respectful maternity care
  • Student
  • Survey

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Maternity and Midwifery


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