Direct observation of respectful maternity care in five countries: a cross-sectional study of health facilities in East and Southern Africa

Publish Date: December 2015
Author: Heather E. Rosen, Pamela F. Lynam, Catherine Carr, Veronica Reis, Jim Ricca, Eva S. Bazant, Linda A. Bartlett
Language: English

This article, published in BMC Pregnancy & Childbirth, analyzes select data from a series of cross-sectional surveys implemented from 2009 – 2012 by MCHIP to assess quality of care in Ethiopia, Kenya, Madagascar, Rwanda and the United Republic of Tanzania. The study used structured, standardized clinical observation checklists to directly observe the quality of care at facilities in the five countries.

A total of 2,164 labor and delivery observations were conducted at hospitals and health centers. Overall, women were treated with dignity and in a supportive manner by providers, but many women experienced poor interactions with providers and were not well-informed about their care. The most frequently mentioned forms of disrespect and abuse reported in the open-ended comments were abandonment and neglect.

The authors note that efforts to increase the use of facility-based maternity care in low-income countries are unlikely to achieve desired gains if the quality of care provided does not improve, especially elements of respectful care. Failure to adopt a patient-centered approach and a lack of health system resources are factors contributing to the poor quality of care.

The authors suggest that further research is needed to understand barriers and develop effective interventions to promote respectful care in this context.

To read the open access article, click here.