Tackling challenges relating to disrespect and abuse in MNH services

Note – content below is from an email update, July 2015

Why does the increasing focus on provision of respectful maternity care (RMC) matter? How does the attitude and behaviour of health workers impact on maternal health outcomes?

In this first of several informal updates, and as part of our work on the Quality of Maternal & Newborn Services learning resource, HEART highlights a selection of recent and topical responses on RMC, including: from the USAID-funded TRAction and MCHIP programmes; from the WHO; and from the White Ribbon Alliance.

#1) An evidence-based typology: USAID-funded research work – the influential TRAction landscape review identified and defined categories of disrespect and abuse (D&A) during delivery – at clinical, facility and health system levels – as a major barrier to the use of services. This typology has recently been built upon by a systematic review of 34 countries, which has gained significant media coverage – see July 2015 BBC and New York Times.

#2) Good practice guidelines: the 2014 WHO Statement on the prevention and elimination of disrespect and abuse during childbirth an outline of WHO’s priority areas on D&A: support for research and action; programmes with a focus on respectful care; emphasis on women’s rights in healthcare; systems for data generation, for accountability and for professional support; and greater stakeholder engagement.

#3) Midwifery-led advocacy efforts: the Universal Rights of Childbearing Women Charter – the White Ribbon Alliance (WRA) has developed a Universal Rights of Childbearing Women Charter , which includes seven core categories of D&A and corresponding rights. WRA aims to make the charter the basis of maternity care systems around the world, and has supported efforts in countries such as Nepal, Kenya, Bangladesh and Yemen, to work it into national laws and strategic action plans.

#4) Practical resources for changing attitudes of MNH service professionals – the MCHIP programme toolkit aims to support clinicians, trainers, managers and other MNH stakeholders to implement RMC in their area of work or influence. At a country-level, the White Ribbon Alliance’s Nigeria-focused Health Workers’ Training Guide (from May 2015) provides a resource, reflecting the Nigerian context, for facilitators to help healthcare providers confront D&A in their own facilities.

Please note:

  • The resources highlighted above are just a selection of recent initiatives / outputs – HEART does not endorse those mentioned.
  • The provision of RMC should be seen as part of a much broader range of challenges in relation to strengthening human resources for health.
  • Following the Cochrane Group framework, this learning resource situates the provision of RMC as part of broader array of ‘Professional Strategies’ for improving quality.
Tackling challenges relating to disrespect and abuse in MNH services was last modified: May 4th, 2016 by Adrian Bannister