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The purpose of this operational guidance is to provide country stakeholders (including policy-makers, program managers and civil society members) with a flexible process to guide the design, implementation, and monitoring of efforts to strengthen respectful maternity care and eliminate mistreatment as part of comprehensive maternal and newborn health programs.

This resource links out to the operational guidance in ENGLISH.

We present a set of indicators that could be used to measure the effects of programs on RMC. Integrating these indicators into programs to improve quality of care and other health system outcomes will facilitate routine monitoring and accountability around experience of care.

This study used data from the WHO multi-country study ‘How women are treated during facility-based childbirth’ in Ghana, Guinea, Nigeria and Myanmar, to describe the characteristics of labour companionship in maternity care settings and explore the relationship between labour companionship and the different types of mistreatment during childbirth.

A guide of tested interventions to promote respectful maternity care. This resource includes links to the files for download, explanation of how to implement the solution, and the logic behind them.

More than a year into the COVID-19 pandemic, mothers and newborns continue to be significantly impacted by theCOVID-19 pandemic. This is partly due to direct risk from COVID-19 infection. However, it is also due to widespread misinformation, poor communication, and implementation of non-evidence-based policies intended to reduce COVID-19 transmission but that actually increased risk to mothers and newborns. Here are five key messages to protect women and newborns and maintain progress toward preventing maternal and newborn mortality.

About the Series

The Self-Care Learning and Discovery Series, held June 24-August 27, 2021 was a highly interactive, virtual forum where participants exchanged and incubated ideas, experiences, and solutions on a variety of self-care topics. Hosted by White Ribbon Alliance (WRA) on behalf of the Self-Care Trailblazer Group (SCTG), the Self-Care Learning and Discovery Series presented new knowledge, elevated self-care solutions, forged connections across issues and geographies, and much more! The series was open to all interested self-care stakeholders, including advocates, health providers, government representatives, implementers, journalists, community leaders, academia, product developers, feminists, youth champions, and more. There was no fee to participate.  

Sessions

The Self-Care Learning and Discovery Series included 16 virtual sessions, organized by diverse partners from around the world, that explored a different self-care topic. Each session featured examples and discussions of self-care evidence, advocacy, and practice through interactive panels, participatory dialogues, and more. All sessions are available in English, French, and Spanish and include English closed captioning. 

Please continue to visit the Self-Care Learning and Discovery Series platform to access self-care session recordings and resources that can be easily downloaded and shared at no cost. 

Background Accountability for mistreatment during facility-based childbirth requires valid tools to measure and compare birth experiences. We analyse the WHO ‘How women are treated during facility-based childbirth’ community survey to test whether items mapping the typology of mistreatment function as scales and to create brief item sets to capture mistreatment by domain.

Methods The cross-sectional community survey was conducted at up to 8 weeks post partum among women giving birth at hospitals in Ghana, Guinea, Myanmar and Nigeria. The survey contained items assessing physical abuse, verbal abuse, stigma, failure to meet professional standards, poor rapport with healthcare workers, and health system conditions and constraints. For all domains except stigma, we applied item-response theory to assess item fit and correlation within domain. We tested shortened sets of survey items for sensitivity in detecting mistreatment by domain. Where items show concordance and scale reliability ≥0.60, we assessed convergent validity with dissatisfaction with care and agreement of scale scores between brief and full versions.

Introduction Mistreatment of women during childbirth is increasingly recognised as a significant issue globally. Research and programmatic efforts targeting this phenomenon have been limited by a lack of validated measurement tools. This study aimed to develop a set of concise, valid and reliable multidimensional measures for mistreatment using labour observations applicable across multiple settings.

Methods Data from continuous labour observations of 1974 women in Nigeria (n=407), Ghana (n=912) and Guinea (n=655) were used from the cross-sectional WHO’s multicountry study ‘How women are treated during facility-based childbirth’ (2016–2018). Exploratory factor analysis was conducted to develop a scale measuring interpersonal abuse. Two indexes were developed through a modified Organisation for Economic Co-operation and Development approach for generating composite indexes. Measures were evaluated for performance, validity and internal reliability.

Introduction Experiences of care and satisfaction are intrinsically linked, as user’s experiences of care may directly impact satisfaction, or indirectly impact user’s expectations and values. Both experiences of care and satisfaction are important to measure so that quality can be monitored and improved. Globally, women experience mistreatment during childbirth at facilities; however, there is limited evidence exploring the mistreatment and women’s satisfaction with care during childbirth.

Methods This is a secondary analysis of a cross-sectional survey within the WHO study ‘How women are treated during facility-based childbirth’ exploring the mistreatment of women during childbirth in Ghana, Guinea, Myanmar and Nigeria. Women’s experiences of mistreatment and satisfaction with care during childbirth was explored. Multivariable logistic regression modelling was conducted to evaluate the association between mistreatment, women’s overall satisfaction with the care they received, and whether they would recommend the facility to others.

Background Evidence has shown the benefits of labour companions during childbirth. Few studies have documented the relationship between the absence of labour companions and mistreatment of women during childbirth in low-income and middle-income countries using a standardised tool.

Methods We conducted a secondary analysis of the WHO multi-country study on how women are treated during childbirth, where a cross-sectional community survey was conducted with women up to 8 weeks after childbirth in Ghana, Guinea, Nigeria and Myanmar. Descriptive analysis and multivariable logistic regression were used to examine whether labour companionship was associated with various types of mistreatment.

The purpose of this operational guidance is to provide country stakeholders (including policy-makers, program managers and civil society members) with a flexible process to guide the design, implementation, and monitoring of efforts to strengthen respectful maternity care and eliminate mistreatment as part of comprehensive maternal and newborn health programs.

This resource links out to the operational guidance in SPANISH: Poner en práctica el Cuidado Materno
Respetuoso para las madres y recién nacidos en los programas integrales de MCSP Guía operativa.

The purpose of this operational guidance is to provide country stakeholders (including policy-makers, program managers and civil society members) with a flexible process to guide the design, implementation, and monitoring of efforts to strengthen respectful maternity care and eliminate mistreatment as part of comprehensive maternal and newborn health programs.

This resource links out to the operational guidance in SPANISH: Mettre en pratique des soins de maternité respectueux dans le cadre de programmes complets de soins maternels et néonatals de MCSP, Directives opérationnelles.