The association between mistreatment of women during childbirth and postnatal maternal and child health care: Findings from “Birth in Brazil”

BackgroundThe mistreatment of women during pregnancy, childbirth, and the puerperium is a global public health problem besides being a violation of human rights. However, research exploring the consequences of mistreatment of women and newborns is scarce.QuestionTo shed light on this issue, we investigated the association between the mistreatment of women during childbirth and the subsequent use of postnatal health services by women and their newborns.MethodsWe used data from the study “Birth in Brazil”, a national hospital-based survey of puerperal women and their newborns, carried out in 2011/2012. This analysis involved 19,644 women. Mistreatment was a latent variable composed of seven indicators. We assessed the attendance of women and newborns to a review consultation following birth, and the timing of this appointment. We applied multigroup structural equation modeling (based on childbirth payment source) and considered separate analysis for women (vaginal births and0 caesarean-sections) and newborns.FindingsWe found a causal association between mistreatment during childbirth and decreased and/or delayed use of postnatal health services, for both women and their newborns. These results also revealed that women who use the public sector are affected more than those who pay for private healthcare.ConclusionMistreatment during childbirth has broader implications than “maternal mental health”, and it would be useful to understand that experience of care has vast implications for families. In Brazil, the mistreatment must be mitigated via the implementation of public policy. This is part of the path to dignified and respectful childbirth care for all women.     

Interactions between formal structures and knowing communities: What does open source community involvement mean?

The purpose of this paper is to study the interactions between formal structures and knowing communities and to show how formal structures can support external communities. Indeed, the literature reveals the critical role of external knowing communities for innovation. This research is based on a sequential mixed-method research design with a multi study sequential approach. Three studies are performed to analyze the interactions between IT formal structures and open source communities. Study 1 and study 3 are quantitative and rely on the same sample of 157 IT business managers. Study 2 is qualitative and is based on four managers of three formal structures deeply rooted in open source communities. These studies show that the use of open source within the formal structure has an impact on the three forms in which formal structures involve themselves in external knowing communities: formalized, result-oriented and inter-connected involvement. They also reveal the difficulties and possibilities of inter-connected involvement and highlight the central role of formalization in community involvement.