A Fresh Series Proposing Approaches to Cease Abuse and Ensure Dignified Maternal and Newborn Care
An escalating collection of proof reveals that the ill-treatment of females in the realm of maternal healthcare is a global concern. For an extended period, the World Health Organization (WHO) and HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction) have been chronicling this infringement of human rights and its repercussions on health and wellness.
The WHO’s guidelines on care during childbirth for a favorable birthing experience encompass several pertinent suggestions. However, scant research has been conducted to ascertain which measures could be effectively instituted—until this moment.
HRP and WHO researchers and associates have recently unveiled a unique series of five scholarly articles in the journal PLOS Global Public Health. These articles delve into a variety of tactics across diverse themes to terminate the abuse of women during labor and foster dignified care.
The inaugural paper in this collection scrutinizes theories of interventions aimed at curtailing physical and verbal mistreatment. Two principal themes arise from this study: firstly, that brutality is considered routine in society, especially against marginalized communities; and secondly, the conviction that the abuse of women is essential to mitigate medical risks.
The authors emphasize that remedies should not merely zero in on the shortcomings of staff via educational sessions or evaluation processes. Rather, they should also pursue enduring solutions that can stimulate lasting alterations in viewpoints and convictions, ultimately leading to a permanent shift in conduct. This would result in a transformation in behavior across the entire spectrum of the healthcare and social service systems, from entry-level healthcare providers to top-tier staff and middle-level managers, and from organizational financiers and evaluators to community leaders, politicians, and other crucial participants.
The authors remark, “The goal is for the ensuing individual, collective, institutional, and societal norms to undergo a deep and lasting change to counteract ‘othering’ at a basic level, and extend into the future, even after the official intervention program has concluded.” Tools from the field of implementation science, which incorporate practical solutions like the theoretically grounded Behavioural Change Wheel, could be advantageous in formulating customized interventions appropriate for each setting.
The second scholarly article focuses on methods to alleviate stigma and prejudice, a vital component of the abuse endured by women. While extensive research has been conducted to portray the stigma and discrimination encountered by women in sexual and reproductive healthcare environments, additional work is required to fully comprehend how to eradicate it.
This novel research thus centers on interventions that could bring about change and accentuates that any healthcare-related policy aimed at enhancing fairness should contemplate the inclusion and assessment of stigma and discrimination. Furthermore, as the authors state, “initiatives to tackle abuse will be futile if stigma and discrimination continue to exist.”
This study offers an examination and suggestions, including a multi-tiered stigma model for sexual reproductive health and rights, which can guide actions and research for the implementation of considerate, individual-focused care for everyone. The authors acknowledge that additional efforts are required to confront and dismantle societal conditions, cultural standards, and organizational rules that affect the prospects and well-being of marginalized populations.
The third recently released article in this series investigates communication tactics to enhance interpersonal interactions and minimize the abuse of women. Two primary methodologies were pinpointed: the education of healthcare providers and the utilization of communication instruments. While the majority of the uncovered interventions are centered on disseminating information, the incorporation of other communication objectives—like relationship establishment and the inclusion of women and their partners in decision-making—could further enrich the care experience for women, their partners, and their families.
The fourth article scrutinizes how organizational and workplace factors can contribute to abuse in low- and middle-income nations. There is mounting evidence on how staffing shortages and other obstacles in healthcare systems can impact respectful maternal care. However, this study identifies and tackles considerable gaps in research related to multiple employment and organizational elements. This encompasses key organizational challenges such as elevated workload, unequal distribution of tasks, absence of professional independence, low remuneration, insufficient education, inadequate feedback and oversight, and workplace brutality.
In reaction, the extensive strategies pinpointed consist of preparations for stressors and shortages of healthcare providers and staff, offering supportive management, enhancing resilience via peer backing, reconfiguring leadership, and alleviating workplace brutality.
The fifth article is a “Critical Interpretive Synthesis,” aiming to deepen the comprehension of the power-related drivers of the abuse of women. It accomplishes this by exploring and amalgamating literature from diverse academic fields to advance both theory and practice on this subject.
The authors identified an array of underlying power-related factors behind abuse at various societal strata, including intrapersonal (e.g., unawareness about one’s rights), interpersonal (e.g., hierarchical relationships between patients and healthcare providers), community (e.g., existing widespread prejudice against indigenous women), organizational (e.g., pressure on healthcare providers to meet performance objectives), and legal and/or policy (e.g., absence of accountability for human rights infringements). The authors conclude that tackling these factors necessitates the participation of a variety of stakeholders, including women, communities, healthcare workforces, and policymakers.
