Many low- and middle-income countries are yet to achieve the sustainable development goal target of lowering the maternal mortality ratio to 70 per 100,000 live births by 2030. To address this issue, a range of maternal health interventions are being implemented.
The World Health Organization created a framework for quality maternal and newborn healthcare. One of the eight domains of this framework is focused on increasing the quality and centering care provision to women during childbirth: Respectful Maternity Care (RMC), which encompasses the “right to dignity, respect, privacy, confidentiality, equality, informed consent, autonomy, and timeliness”.
Asefa et al. (2020) delved into understanding health system constraints to the promotion of respectful maternity care by conducting a study in three public hospitals in Ethiopia. According to Asefa et al. (2020), despite the practice of service providers being one of the main determinants of RMC, other system components, such as infrastructure, information and referral systems, funding, motivation, and many others, affect the delivery of RMC. In their research, they have identified seven health system components affecting the promotion of RMC: bed availability, infrastructure and supplies, financing, health workforce, staff motivation, service providers’ mindset, and awareness of RMC. They have noted the shortage of beds as the main challenge in implementing RMC, as they had to decline patients. Most women also prefer to come to hospitals rather than lower-level health facilities believing that they would receive better service. Because of overcrowding, some women who are in labor had to wait in corridors while some had to be referred to other facilities. Privacy issues, facility constraints, and financial bottlenecks which led to heavier workload and frustration for service providers also posed concerns in providing respectful care.
The article has shown a perspective on how the health system as a whole affects the provision of Respectful Maternal Care (RMC). RMC has a truly important role in promoting maternal and newborn health and in decreasing the maternal mortality ratio. Addressing issues of the health system as a whole can help in implementing and promoting RMC.
Reference
Asefa, A., McPake, B., Langer, A., Bohren, M. A., & Morgan, A. (2020). Imagining maternity care as a complex adaptive system: Understanding health system constraints to the promotion of Respectful Maternity Care. Sexual and Reproductive Health Matters, 28(1). https://doi.org/10.1080/26410397.2020.1854153