Childbirth experiences for women living with HIV in Kilimanjaro, Tanzania: a mixed method study on respectful maternity care.

Background: Respectful maternity care (RMC) is important for women living with human immunodeficiency virus (WLHIV) to promote their well-being and long-term healthcare engagement. This descriptive mixed-methods study explored the experiences of RMC during childbirth among WLHIV in Tanzania.

Methods: We conducted a mixed-methods study and recruited 103 WLHIV from six healthcare facilities within 48 h 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.

Results: In the survey, self-reported RMC was overall high. 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 suggested a general appreciation of the care received, but some participants reported that providers neglected them, avoided physical contact or did not seek their consent for procedures.

Conclusions: These data suggest an opportunity for additional provider training in clinical empathy and patient-centred practices to address the unique needs of WLHIV and enhance their overall maternity care satisfaction and health outcomes. There is also a need for investments in clinical infrastructure to support the delivery of RMC.