International Day for Maternal Health and Rights

By Sarah Weber and Emily Peca, TRAction Project, University Research Co.

On this week of celebration and promotion of maternal health and rights, we bring attention to the many women who are denied respectful childbirth experiences in health facilities. Despite international human rights conventions, and most recently, the World Health Organization’s statement on “Prevention and elimination of disrespect and abuse during childbirth”, women in many parts of the world still experience disrespectful and abusive childbirth care ranging from physical and emotional abuse to neglect, lack of privacy, consent and unfair requests for payment. International mandates promote the importance of facility-based childbirth—but how can we be content sending women to facilities that betray their trust and strip them of dignity?  

To shine light on this problem, the USAID|TRAction Project, led by University Research Co. is supporting implementation science studies that describe, measure and (in some cases) develop interventions to address D&A during childbirth. Through this process these studies have empowered women in local communities to tell their stories, as well as take active roles in conducting research to identify and address barriers to respectful maternal care. Not only were women the subject of the research effort, they were also empowered to conduct the activities themselves. Below, two women share their experience as data collectors for the TRAction Project in their home region of Guatemala.   

______

For me the TRAction Project effort in Ixil was my first work experience in which we prioritized involving women in research.  Not only were women participants involved in identifying problems, but women who gave birth at home, and in health facilities, along with traditional birth attendants were given space to talk about maternal health. 

These women were able to reflect on their birth experiences, and the care they received.  Women who gave birth at home were the center of attention, but in health facilities women often mentioned being treated poorly. 

I learned a lot from these women and from the team who helped us have the confidence to complete this work.

–Elena, supervisor

______

It was gratifying to share life experiences with the women we interviewed, especially because they are indigenous women living in difficult conditions with poor access to health services (water), justice, education, among other necessities for human development.

We know to avoid maternal deaths we have medical interventions like cesarean sections, but these interventions devalue the culture, customs and traditions of these women.  And to hear that health services do not have the resources to provide good care to women is sad. Knowing when obstetric complications arise women are vulnerable to giving birth en route to a facility many kilometers away is devastating!

–Magdalena, facilitator

                                ______

In addition to the work being done to measure and address D&A in Guatemala, the TRAction Project is also investing in efforts to better understand treatment of women during childbirth at health facilities in Tanzania and Kenya.  The Population Council is working in Kenya and Averting Maternal Death and Disability/Columbia University and Ifakara Health Institute are working in Tanzania. These organizations conducted implementation research studies that measured disrespect and abuse, and tested interventions to address the issue in each context. These studies operated at national, district and community levels to empower communities, strengthen health systems and make the policy environment more favorable toward maternal health and rights.  Some of the work has been published and more is forthcoming. http://bit.ly/ReduceDAinKenya, http://bit.ly/DAinTanzania, http://bit.ly/DAGlobal, http://bit.ly/AdvancingRMC. 

This cutting edge work uncovers breaches of maternal health and human rights that can no longer go unnoticed. If we measure this problem we can no longer deny it. It is time to build on human rights rhetoric, and use the emerging evidence to make health systems accountable so that every woman has the right to respectful and dignified care during childbirth. 

The TRAction Project has shown that by empowering women to understand their maternal health rights and speak about issues of D&A, barriers can be identified and addressed to help improve maternal care during childbirth. To learn more about the TRAction Project’s work to improve respectful maternal care, please visit our website at www.tractionproject.org.