Woman-Centered Respectful Care
Having just given birth the day before, Violet Ziratsi waits with other mothers to see a midwife for vaccinations and health education tips at the postnatal clinic at Gonja Lutheran Hospital in the Pare Mountains of Northern Tanzania.© 2012 FELM/organization, Courtesy of Photoshare
Around the world, in both industrialized and low- and middle-income countries, women who give birth in health facilities often face undignified conditions and poor quality of care. A review commissioned by USAID’s Translating Research into Action (TRAction) Project related to childbirth experiences identified seven categories of disrespect: physical abuse, clinical care without patient consent, non-confidential care, non-dignified care (including verbal abuse), discrimination based on patient attributes, abandonment of care, and detention in facilities (Bowser and Hill 2010). The World Health Organization’s vision for quality maternal and newborn care and accompanying standards build upon this initial typology and identifies the provision of care and experience of care (how women are treated), as critical components of quality that can influence service utilization, and, ultimately, health outcomes. Mistreatment can affect care-seeking across the continuum of services—especially when families are faced with limited resources and difficult choices. Additionally, health system constraints can result in disrespect and abuse of health workers—many of whom are women. Ensuring respectful care of both clients and providers is a complex challenge involving individual and health system level constraints such as health provider workload, infrastructure and supply challenges, gender dynamics and health system management.
The Implementation Science Collaborative will build on the ground-breaking respectful maternal care work and other efforts around respectful maternity care to support research-to-use activities that advance a woman-centered care more broadly—to ensure respect and dignity across the continuum of care.
- Community and health system intervention to reduce disrespect and abuse during childbirth in Tanga Region, Tanzania: A comparative before-and-after study – Columbia University, Averting Maternal Death and Disability (AMDD)
- Exploring provider perspectives on respectful maternity care in Kenya: “Work with what you have”. – Population Council
- Sowing the seeds of transformative practice to actualize women’s rights to respectful maternity care: reflections from Kenya using the consolidated framework for implementation research. – Population Council