ASSESSMENT OF MIDWIVES' KNOWLEDGE AND ATTITUDES TOWARDS REPRODUCTIVE HEALTH RIGHTS AND WOMEN'S REPRODUCTIVE HEALTHCARE EXPERIENCES AT GENERAL HOSPITAL, IJAN-EKITI.

TOPIC: ASSESSMENT OF MIDWIVES' KNOWLEDGE AND ATTITUDES TOWARDS REPRODUCTIVE HEALTH RIGHTS AND WOMEN'S REPRODUCTIVE HEALTHCARE EXPERIENCES AT GENERAL HOSPITAL, IJAN-EKITI.

THIS TOPIC IS ALSO SUITABLE FOR:
1. Department of Nursing Science
2. Department of Midwifery
3. Department of Public Health
4. Department of Community Health
This research material contains:
1-Chapter One to Five
2-Recent References/citations
3-Tables/Charts/Graphs in Chapter Four
4-Accurate Data Analysis
5-Table of Contents
6-Questionnare

ABSTRACT
This study was carried out to assess midwives' knowledge and attitudes towards reproductive health rights and women's reproductive healthcare experiences at General Hospital, Ijan-Ekiti. The study was specifically carried out to assess the level of knowledge of midwives regarding women's reproductive health rights at General Hospital, Ijan-Ekiti, examine the attitudes of midwives towards the promotion and protection of women's reproductive health rights at General Hospital, Ijan-Ekiti, evaluate women's reproductive healthcare experiences in relation to the services provided by midwives at General Hospital, Ijan-Ekiti, and assess the influence of midwives' attitudes towards reproductive health rights on the quality of reproductive healthcare experienced by women at General Hospital, Ijan-Ekiti. The study employed the descriptive survey research design. Hence, the questionnaire was used for data collection, while the data collected were analyzed using descriptive and inferential statistics. The hypotheses were tested using Pearson Chi-square statistical tool. A total population of 150 women attending General Hospital, Ijan-Ekiti was used for the study, while a sample size of 109 respondents was determined using the Taro Yamane formula and selected through a multi-stage sampling technique involving stratified and convenience sampling methods. However, 94 validated questionnaires were retrieved and used for the analysis. From the responses obtained and analyzed, the findings revealed that midwives possessed a significant level of knowledge regarding women's reproductive health rights at r = 0.681, t = 8.915, P = 0.013. The study also showed that midwives demonstrated significant positive attitudes towards the promotion and protection of women's reproductive health rights at r = 0.638, t = 7.938, P = 0.021. Likewise, the study further revealed that women's reproductive healthcare experiences were significantly related to the services provided by midwives at r = 0.714, t = 9.772, P = 0.009. The study additionally established that midwives' attitudes towards reproductive health rights significantly influenced the quality of reproductive healthcare experienced by women at r = 0.756, t = 11.094, P = 0.006. The study therefore recommends that hospital management should organize regular training programmes to strengthen midwives' knowledge of reproductive health rights, while healthcare administrators should ensure continuous monitoring of respectful maternity care practices to improve the quality of reproductive healthcare services.
Keywords: Midwives, Reproductive Health Rights, Women's Reproductive Healthcare, Knowledge, Attitudes.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background to the Study
Reproductive health has been an integral part of health systems worldwide because of its impact on maternal health, population dynamics, and the development of societies. It has been defined as a state of physical, mental and social well-being related to the reproductive system, as well as the absence of disease or infirmity (Leung et al, 2022). International health frameworks have highlighted the need to view reproductive health as a strategy to improve health outcomes in populations by making it a part of primary care (Bradfield et al, 2023). Likewise, Opoku-Danso et al, (2023), also observed that reproductive health services were now being integrated into universal health coverages agenda in a bid to enhance service access and equity. In addition, Ahmad (2024) noted that reproductive health interventions had progressed to meet the life course needs including adolescence, childbirth, and post natal care. In this global context, reproductive health rights are defined as the rights that people have to make choices about their own reproductive processes without coerced or discriminatory pressure, and that supports dignity and autonomy in health service interactions.
Reproductive health rights are understood to be human rights to guarantee access to safe, acceptable and quality reproductive health services, information and autonomy in making reproductive health decisions. When these rights are put into practice effectively at the health system level, these rights have been associated with better maternal health outcomes, according to Ogbuabor et al, (2021). Ebong et al (2023) defined women's reproductive healthcare experiences as subjective and interpersonal encounters women experience while accessing services like antenatal care, delivery, and postnatal support. Daniel et al (2023) also pointed out that provider communication, respect and perceived quality of care influenced these experiences. In the same vein, Leung et al, (2022) observed that respectful maternity care had become a defining factor of good healthcare experiences for women. All these together emphasize the need for rights-oriented approaches in reproductive health care, in which dignity and autonomy of women are expressed and valued, and have an impact on the provision and use of health services.
The midwife is a pivotal role in providing reproductive healthcare services because of the ongoing contact with women before, during, and after childbirth. Their knowledge is about how much they know about reproductive health principles, clinical procedures and rights based care practices and their attitudes are about their dispositions and behavioural inclinations towards respecting women's reproductive autonomy. According to Monne et al, (2024), the competencies of midwives had a significant impact on the quality of delivery of maternal healthcare. Makelele et al (2025) also found a correlation between positive attitudes among midwives and increased satisfaction and confidence in healthcare systems by their patients. Thommesen et al (2024) highlighted the need for continuous professional development to boost the midwives' compliance to reproductive health rights. Midwives were also identified as central to the implementation of reproductive health policies as they act as intermediaries between the policy and the experiences of women in care, as observed by Adelekan et al, (2024). These related jobs make it important to measure their knowledge and attitudes in a health care environment.
However, the rights to reproductive health and women's healthcare experiences have been incorporated into various countries' health policies to support respectful and equitable healthcare. According to Ogbuabor et al, (2021) healthcare providers' awareness of reproductive rights had affected the pattern of service delivery in the various health facilities in Nigeria. Ebong et al, (2023) similarly noted disparities in women's health care experiences in various regions, which are sometimes due to provider competency and systemic issues. At secondary level healthcare (general hospital, Ijan-Ekiti) in Ekiti State, healthcare delivery demonstrates the actualization of these concepts with the midwife as a key player in the vital services to mothers. Ahmad (2024) highlighted the importance of knowledge and attitudes of providers at facility level for enhancing reproductive health systems. This study thus falls into this context to investigate the knowledge and attitude of midwives on women reproductive health rights and women reproductive health care experiences in General Hospital Ijan-Ekiti.

1.2 Statement of  the Problem    
Reproductive health services are still an integral part of maternal and child health delivery systems worldwide, including those where midwives have a central role in the provision of health services, and in particular in hospitals. In the current healthcare context, a focus has been placed on reproductive health rights as an integral part of quality health services, ensuring women are treated with dignity, respect and information during reproductive health services (Ogbuabor et al, 2021; Bradfield et al, 2023). In the same vein, Leung et al, (2022) and Opoku-Danso et al, (2023) reported that health care systems have increasingly adopted rights-based approaches to enhance the quality of health care services and patient satisfaction. Midwives should be knowledgeable about the rights related to reproductive health and have positive attitudes that promote women's autonomy and health care experiences. But, professional knowledge and attitude still play a role in the implementation of these standards in clinical practice.
While reproductive health rights play a crucial role in determining maternal care, evidence indicates that there are gaps in midwives' knowledge and attitudes that ultimately impact women's reproductive health care experiences. Ebong et al, (2023) and Daniel et al, (2023) indicate that women's experiences in health care facilities are often influenced by the behaviour, communication styles and respectful care practices of providers. Ideal scenarios in which midwives consistently support reproductive health rights do not necessarily exist in many contexts - and there are policy-to-practice disconnects. Additionally, Monne et al (2024) and Makelele et al (2025) suggested that these differences could lead to inconsistencies in the quality of care provided and patient satisfaction. This gap necessitates a systematic review of midwives' knowledge and attitudes to plan for any gaps and reinforce reproductive healthcare delivery with a rights-based approach.
Although policy efforts are on-going, reproductive health rights in midwifery practice in Nigeria, especially in secondary health care institutions like General Hospital, Ijan-Ekiti, are not consistent. Midwives play a crucial role in providing care to women during their pregnancy, labor, and postpartum period, but their knowledge about the principles of rights-based care may not be sufficient (Thommesen et al, 2024; Adelekan et al, 2024). The situation implies that women still have some experience receiving health services that do not embody dignity, respect, and autonomy, a way of providing services that was envisioned in the ideal framework. As pointed out by Ahmad (2024) and Ogbuabor et al, (2021); this is a crucial knowledge gap in comprehending the role of midwives' competencies and attitudes on service outcomes. This study, therefore intends to fill this gap by evaluating the views, attitudes and knowledge of midwives on reproductive health rights and women's reproductive health care service experience at General Hospital, Ijan-Ekiti.
1.3 Objectives of the Study
The study's main goal is to assess midwives' knowledge and attitudes towards reproductive health rights and women's reproductive healthcare experiences at General Hospital, Ijan-Ekiti. The study specifically attempted to: 
1.To assess the level of knowledge of midwives regarding women's reproductive health rights at General Hospital, Ijan-Ekiti.
2.To examine the attitudes of midwives towards the promotion and protection of women's reproductive health rights at General Hospital, Ijan-Ekiti.
3.To evaluate women's reproductive healthcare experiences in relation to the services provided by midwives at General Hospital, Ijan-Ekiti.
4.To assess the influence of midwives' attitudes towards reproductive health rights on the quality of reproductive healthcare experienced by women at General Hospital, Ijan-Ekiti.
Other parts of chapter one include:
1.4 Research Questions: 
1.5 Hypotheses
1.6 Significance of the Study
1.7 Scope of the Study 
 1.8 Operational Definition of Terms

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of reproductive health rights, the concept of midwives' knowledge of reproductive health rights, midwives' attitudes towards reproductive health rights, women's reproductive healthcare experiences, factors influencing women's reproductive healthcare experiences, and the relationship between midwives' knowledge and attitudes and women's reproductive healthcare experiences etc. The chapter is sub-grouped into the following major headings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Presented below is a snapshot of key areas of the study methodology, the full and detail chapter three methodology is contained in the instant download document.

Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises women seeking reproductive health care services at General Hospital, Ijan-Ekiti, Ekiti State.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 109 participants.
Sampling Technique: The study employed a multi-stage sampling technique comprising stratified and convenience sampling methods to select the respondents.
Research Instrument: The study utilized a structured questionnaire titled “Assessment of Midwives' Knowledge and Attitudes Towards Reproductive Health Rights and Women's Reproductive Healthcare Experiences at General Hospital, Ijan-Ekiti” as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their opinions. Inferential statistics, such as Pearson Chi-square, were used to test the hypotheses.
Full outline for chapter three;
3.1 Research Design
3.2 Research Setting
3.3 Target Population
3.4 Sample Size
3.5 Sampling Technique
3.6 Instruments For Data Collection
3.7 Validity and Reliability of Instrument
3.8 Pilot Study
3.9 Method of Data Collection
3.10 Method Of Data Analysis
3.11 Ethical considerations

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables and charts. Based on the results obtained from the analysis, the following major findings were made:

i. The study found that midwives at General Hospital, Ijan-Ekiti had a significant level of knowledge regarding women's reproductive health rights, as evidenced by their responses on the knowledge of reproductive health rights, including non-discrimination, informed decision-making, privacy, confidentiality, informed consent, and respectful treatment. The corresponding hypothesis test showed a correlation coefficient (r) of 0.681, t-value of 8.915, and p-value of 0.013 (p < 0.05), leading to the rejection of the null hypothesis.

ii. The study found that midwives at General Hospital, Ijan-Ekiti had significant positive attitudes towards the promotion and protection of women's reproductive health rights, as evidenced by their commitment to respectful treatment, explaining healthcare procedures, encouraging women's participation in healthcare decisions, and promoting equal access to reproductive healthcare services. The corresponding hypothesis test showed a correlation coefficient (r) of 0.638, t-value of 7.938, and p-value of 0.021 (p < 0.05), leading to the rejection of the null hypothesis.

iii. The study found that women's reproductive healthcare experiences were positively related to the services provided by midwives at General Hospital, Ijan-Ekiti, as evidenced by respectful treatment, adequate information, privacy, confidentiality, involvement in healthcare decisions, and satisfaction with services received. The corresponding hypothesis test showed a correlation coefficient (r) of 0.714, t-value of 9.772, and p-value of 0.009 (p < 0.05), leading to the rejection of the null hypothesis.

iv. The study found that midwives' attitudes towards reproductive health rights significantly influenced the quality of reproductive healthcare experienced by women at General Hospital, Ijan-Ekiti, as evidenced by the importance of positive attitudes, friendly communication, respect for women's rights, and respectful treatment in improving healthcare quality and encouraging utilization of reproductive healthcare services. The corresponding hypothesis test showed a correlation coefficient (r) of 0.756, t-value of 11.094, and p-value of 0.006 (p < 0.05), leading to the rejection of the null hypothesis.

CHAPTER FIVE: DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings   
5.2 Implication of the findings
5.3 Limitations of the Study
5.4 Summary 
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies
Reference
Appendix

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