Women and birth : journal of the Australian College of Midwives · 2026
Promoting respectful maternity care in Nepal: A mixed-methods one-year follow-up of a pilot Forum Play intervention with hospital staff.
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Paudel Ghimire Narayani, Dahal Pranab, Joshi Sunil Kumar, Swahnberg Katarina
Аннотация
BACKGROUND: Respectful maternity care promotes dignity, privacy, informed choice, and equitable treatment during childbirth. However, disrespect and abuse remain common, particularly in low- and middle-income countries such as Nepal, where evidence on sustainable interventions is limited. Forum Play is a participatory theatre-based approach using role-play, reflection, and dialogue.
AIM: To assess changes over one year in hospital staff's perceptions and self-reported behaviour regarding disrespect and abuse following participation in a pilot Forum Play intervention and to explore its contribution to respectful maternity care.
METHODS: A mixed-methods follow-up study was conducted in November 2024 among tertiary hospital staff in Kathmandu, one-year post-intervention. Quantitative data were collected through a self-administered questionnaire (n = 30) and analysed across pretest, two-month posttest, and one-year follow-up using descriptive and inferential statistics. Qualitative data were obtained through focus group discussions (n = 22) and in-depth interviews (n = 6) and analysed using inductive qualitative content analysis.
FINDINGS: Recognition of disrespect and abuse increased significantly, with greater identification of incidents and regret for not intervening (p = <0.05). Perceptions of respectful maternity care remained positive and stable from pretest to follow-up (p = 0.69). Qualitative findings indicated that disrespect and abuse were often normalised and shaped by hierarchical relationships, medicalized care, and systemic constraints. Forum Play enhanced awareness, empathy, and communication despite ongoing structural barriers.
CONCLUSIONS: Forum Play showed promise in promoting respectful maternity care by encouraging reflection and strengthening empathy and communication among hospital staff. Sustaining these changes, however, requires broader institutional and health system support.
AIM: To assess changes over one year in hospital staff's perceptions and self-reported behaviour regarding disrespect and abuse following participation in a pilot Forum Play intervention and to explore its contribution to respectful maternity care.
METHODS: A mixed-methods follow-up study was conducted in November 2024 among tertiary hospital staff in Kathmandu, one-year post-intervention. Quantitative data were collected through a self-administered questionnaire (n = 30) and analysed across pretest, two-month posttest, and one-year follow-up using descriptive and inferential statistics. Qualitative data were obtained through focus group discussions (n = 22) and in-depth interviews (n = 6) and analysed using inductive qualitative content analysis.
FINDINGS: Recognition of disrespect and abuse increased significantly, with greater identification of incidents and regret for not intervening (p = <0.05). Perceptions of respectful maternity care remained positive and stable from pretest to follow-up (p = 0.69). Qualitative findings indicated that disrespect and abuse were often normalised and shaped by hierarchical relationships, medicalized care, and systemic constraints. Forum Play enhanced awareness, empathy, and communication despite ongoing structural barriers.
CONCLUSIONS: Forum Play showed promise in promoting respectful maternity care by encouraging reflection and strengthening empathy and communication among hospital staff. Sustaining these changes, however, requires broader institutional and health system support.