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Research on Disrespect and Abuse during Childbirth: Experts Discuss Advancements and Challenges
This blog is cross-posted here on the USAID|Translating Research into Action (TRAction) Project website.
The issue of disrespect and abuse (D&A) during childbirth is a widespread problem that affects women in both low and high income countries, as described in this recent statement by the World Health Organization (WHO). D&A at health facilities contributes to women's underutilization of skilled delivery services, which may negatively impact women's health. Thus, respectful and dignified care is central to improving women's health worldwide.
On November 11, 2014, a webinar hosted by the Center for Health and Gender Equity (CHANGE) brought together three panelists to discuss cutting-edge research on D&A while opening a dialogue on how this research can shape policy advocacy. The panelists stressed the complex nature of D&A, and suggested that an effective response must be systemic.
Kate Ramsey, Senior Research Officer at the Averting Maternal Death and Disability Program (AMDD) at Columbia University, highlighted recent developments from the TRAction-funded STAHA Project, which researches D&A in Tanzania. One of the project objectives is to develop a definition of D&A based on multiple dimensions, including individual behaviors, women's perspectives, providers' intent to harm, and systemic factors. Study findings suggest that independent observers' reports of D&A were significantly higher than women's self-reports, which may be due to the fact that women tend to normalize their experiences of abuse.
While D&A is often attributed to the behaviors of providers, Charlotte Warren, Senior Associate at the Population Council, emphasized that health workers' behaviors are often the result of stressful working conditions. Warren, whose research is based on the TRAction-funded Heshima Project in Kenya, stressed the importance of "caring for the careers," which can be achieved through values clarification and attitude training (VCAT) and providing counseling services with health facility nurses.
Joshua Vogel, Researcher at WHO, encouraged a reconceptualization of D&A that situates it within the broader context of human rights. This may help galvanize support from a wider range of stakeholders and create new opportunities for policy advocacy and grassroots mobilization.
Following the presentations, an illuminating Q&A session addressed the challenges facing this emerging field, and provided suggestions for the way forward. As this burgeoning movement to study, document and advocate against disrespect and abuse during childbirth expands, discussions on such developments will continue to inform the work that facilitates and encourages utilization of skilled delivery for women around the world.
Click here to learn more about TRAction's work on respectful maternal care.
November 14, 2014