Veronica Reis is an MD/ObGyn, with a MPH and PhD in International Health and more than 20 years of experience in reproductive and maternal health. She is from Brazil where she worked in the MoH coordinating the national program for humanization of childbirth from 2003-2005. Dr. Reis has been working for Jhpiego/Jhons Hopkins University for the last 20 years as a Senior technical SR/MNH advisor, providing technical support for countries in Africa, Latin America and Asia. Dr. Reis is also member of the Global Respectful Maternal Care Council.
Respectful Maternity Care (RMC) is increasingly recognized as central to quality maternal and newborn health care, and is defined as an approach centered on the individual and based on principles of ethics that recognizes and promotes women’s rights, including respect for their autonomy, dignity, feelings, choices, and preferences. While a movement advances to promote RMC globally a gap exists on the programmatic interventions to support its implementation. In order to guide policy makers and program managers in RMC programming a survey was conducted collecting information about countries experiences implementing interventions to promote RMC.A literature review was conducted and questionnaires were sent to a convenience sample of 80 individuals (doctors, nurses, midwives, managers and teachers) working in maternal and neonatal health field from 25 countries in 5 continents, with a 60% response rate. A descriptive analysis was carried out on the responses for each program type, experiences and response frequencies by category. Categories included program type, main results, challenges, lessons learned and recommendations. Data was analysed in order to guide policy makers and program managers who are planning RMC interventions in similar contexts.
Main results:interventions implemented to promote RMC were reported by the following percentage of respondents (%): Training (60); quality improvement approaches (58); developing clinical guidelines (58); community activities (46); strengthening local policies (42). Interesting example was Mozambique that linked RMC with quality Improvement effort using Jhpiego developed “Standard Based Management and Recognition” approach. As a result, it was observed better performance in 124 maternities, with improvement by 2014 of indicators that used to be 0% in 2009: delivery with companion increased to 58%; deliveries in a vertical position to 27%; skin-to-skin contact and early breastfeeding to 87%; increased providers and client satisfaction.In conclusion, the survey demonstrates thatinterest in promoting RMC exists in many countries. A number of consistent results emerged across a range of RMC interventions offering valuable guidance for design and implementation of RMC programs. Recommendation for successful implementation of RMC included:the need for political commitment; incorporation of key elements of RMC into laws, rules, and policies; budgetary commitment; development of standards and guidelines; recognition and support for committed teams; incorporation of a gender and rights perspective; advocacy at all levels.
Audience take away:
- Survey on countries experiences implementing interventions to promote RMC provided a broad array of insights that can guide policy makers, program managers and health workers in RMC programming.
- The perspective of key stakeholders from several countries is invaluable in showing what is happening in the field. Many of the Lessons Learned and Recommendations from the respondents reflect an ambitious and approach to implementation of the RMC agenda around of the world.