Among the urgent public health issues that need to be addressed is the mistreatment of women during facility-based childbirth. This results in the violation of women’s rights and the suboptimal uptake of life-saving maternal health services. Respectful maternity care (RMC), as defined by the World Health Organization (WHO) is “the care organized for and provided to all women in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth”. It can be a powerful approach to improve the provision of person-centered care, including the elimination of the said mistreatment of women in health facilities. It also aids for the continuum of care that a woman should receive during pregnancy, childbirth, and postpartum periods. Indeed, labor and childbirth can be difficult for women, especially that vulnerability in the continuum and prevalence of mistreatment can be the highest at these times. Mistreatments also extend to newborn during the immediate postnatal period. As a result, the rights of the newborn are being compromised and the trust of women in the system and future healthcare utilization are being broken and lost.
The provision of respectful maternity care is also among those affected by the different health system barriers. These include the shortage of beds, supplies and health workforce, financial bottlenecks, weak referral system, and demotivation of healthcare workers. Another is the occurrence of a pandemic and health crisis like the COVID-19. The lack of face-to-face consultation limits the extent of support provided for women and their newborns and those in far-flung areas are unable to utilize the new mode of health delivery through teleconsultation. There are six themes of how the pandemic negatively affected health care workers’ ability to provide Respectful Maternity Care. These are:
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Less family involvement
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Denial of birth companionship
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Restrictions on postnatal visitation
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Newborn separation from parents or family members
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Reduced emotional support to women
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Reduced physical support for women
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Compromised standards of care
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Increased risk of medically unjustified cesarean section
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Overwhelmed staff with rapidly changing guidelines and enhanced infection prevention measures
Study revealed that the basic necessities of maternal and child care such as early breastfeeding, birth companionship, and kangaroo mother care could not be ensured during the COVID-19 pandemic as a result of the restrictive guidelines. It is important to understand how and in what aspect does the pandemic affect the provision of respectful maternity care in order to prepare for future sudden disruption in the health system like the COVID pandemic and develop evidence-based strategies to aim for a progress towards the Sustainable Development Goals. The six themes of RMC affected by the pandemic show that the high-quality care described by the WHO standards for quality of maternal and newborn care is being compromised. The negative impacts and the pandemic as its source indicate that these should be addressed from a multidimensional health system to strengthen the perspective in ensuring the sustainability of results. The essential services must be kept running with little or no disruption to RMC by the provision of a local capacity that translates emerging evidence and global guidelines into context-adapted strategies. The growing focus on maternity care and opportunities that come along with the COVID-19 pandemic, if successfully acted upon, could present innovative and creative approaches to advancing the quality of maternity care generally and RMC particularly, even after the pandemic.
REFERENCE:
- Asefa, A., Semaan, A., Delvaux, T., Huysmans, E., Galle, A., Sacks, E., Bohren, M.A., Morgan, A., Sadler, M., Vedam, S., Benova, L. (2021). The impact of COVID-19 on the provision of respectful maternity care: Findings from a global survey of health workers. Women and birth. 2021, ISSN 1871-5192, https://doi.org/10.1016/j.wombi.2021.09.003.