In the course subject N13, we were provided information on the role of the nurse in the public health setting. Thus, we have touched the lack of accessible healthcare in far-flung areas or poor communities. So, I wondered, what is the state of maternity care in informal settlements?
The article I read tackles the importance of birth centers situated near informal settlements to improve reproductive outcomes of the residents.
The latest data on the population living in slums in the Philippines records 42.9% in 2018 (World Bank, n.d.). These areas are frequently located in environmentally hazardous settings where hygiene and sanitation is poor, leading to poor health outcomes. As these settlements are not formally recognized by the government, both social and health services are rarely provided. In these areas, there are also higher rates of STDs, unintended pregnancies, which could negatively impact the country’s goal of lowering maternal mortality and morbidity in the country.
Given the lack of health services, women will most likely have unattended, out-of-facility labor and delivery. If there was some type of attendance, it would be by underqualified or untrained personnel in a substandard facility with lacking supplies. And while it has already been established that the presence of delivery facilities had positive outcomes in terms of delivery, there is a lack of programs that provide the same service to those living in informal settlements.
The article suggests a birth center model of care where the properly trained midwife’s role is emphasized. Among the philosophies of midwifery care are honoring normal physiologic birth without unnecessary interventions while having the knowledge and skills to execute interventions may complications arise, ability to maximize and use available resources efficiently, and to work in partnership with women in providing woman- and family-centered care. Midwifery practice also puts an emphasis on the autonomy, respect, and cultural sensitivity which are all in line with being able to provide respectful maternity care.
What I’d like to dive more into, however, are the core values of respect and cultural sensitivity, which are even more significant in the low resource setting. The socioeconomic and cultural situation of a woman who is a resident of informal settlements is very different. A culturally appropriate care must be provided to make sure that it is tailored to the woman’s needs. Decision making and empowerment of women must be promoted where care provided is free of disrespect and abuse.
The article provides empirical evidence on how the funding of birth centers equipped with necessary equipment and properly trained and regulated midwives in close proximity to informal settlements can provide maternity care for all.
Article:
Wallace, J. (2018, June 4). Using a Birth Center Model of Care to Improve Reproductive Outcomes in Informal Settlements—a Case Study. https://link.springer.com/article/10.1007/s11524-018-0257-3
Reference for statistics:
World Bank. (n.d.). Population living in slums (% of urban population) - Philippines. https://data.worldbank.org/indicator/EN.POP.SLUM.UR.ZS?locations=PH