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I170 THE ROLE OF MIDWIVES & OBSTETRICIANS IN DELIVERING RESPECTFUL MATERNITY CARE
Invited presentations and presentations by organisations and societies / International Journal of Gynecology & Obstetrics 119S3 (2012) S161–S260
I168 IJGO AUTHOR WORKSHOP: AN INSIDER’S GUIDE TO GETTING PUBLISHED T. Johnson1 , R. Adanu2 , V. Obama3 , V. Guinto4 , C. Sosa5 , C. Addington6 . 1 IJGO Editor-in-Chief ([email protected]); 2 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 3 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 4 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 5 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 6 IJGO Managing Editor (clare@figo.org) General overview of the session: An opportunity to learn more about how to maximize your chances of getting your research published from the IJGO Editorial team. From manuscript preparation, submission requirements, understanding the submission process and what’s happening at each stage, to top tips and insights from IJGO’s Editor and Associate Editors. I169 THE RESPECTFUL MATERNITY CARE CHARTER: A COLLABORATIVE WORK R.R. Jolivet Human rights are fundamental entitlements due to all people, recognized by societies and governments and enshrined in international declarations and conventions. A new charter, Respectful Maternity Care: the Universal Rights of Childbearing Women aims to address the problem of disrespect and abuse among women seeking maternity care and provide a platform for improvement by: • Raising awareness of childbearing women’s inclusion in guarantees of human rights recognized in internationally adopted standards and covenants; • Highlighting the connection between human rights language and key program issues in maternity care; • Increasing the capacity of maternal health advocates to participate in human rights processes; • Aligning childbearing women’s sense of entitlement to highquality maternity care with international human rights community standards; and • Providing a basis for holding maternal care systems and communities accountable to these rights. By drawing from established human rights instruments, the Charter demonstrates the legitimate place of maternal health rights within the broader context of human rights. Seven rights are included, corresponding to the seven categories of disrespect and abuse identified in the literature by Bowser and Hill (2010) in their review, “Exploring Evidence for Disrespect and Abuse in Facilitybased Childbirth: Report of a Landscape Analysis”. This charter was developed collaboratively by a multi-stakeholder group with expertise bridging research, educational, clinical, human rights, and advocacy perspectives. This presentation describes that process and methodology. I170 THE ROLE OF MIDWIVES & OBSTETRICIANS IN DELIVERING RESPECTFUL MATERNITY CARE R.R. Jolivet Evidence from 34 countries around the world documents physical assault, verbal insults, discrimination, abandonment, or detention without legal authority, perpetrated against childbearing women in maternal health facilities. Too often, women seeking maternity care receive treatment from their providers that ranges from disrespect to outright abuse, violating their basic human rights and the trust that is the foundation of the patient-provider relationship. Research suggests that fear of ill treatment can be a greater deterrent than cost or distance in the decision to seek facility-based maternity care. Furthermore, analysis of the available evidence suggests disrespect and abuse are associated with poor clinical
S203
quality of care, imposing undue risk on those women who seek skilled attendance in maternal health facilities. With support from USAID, the White Ribbon Alliance is working with partners from clinical, educational, research, human rights, and advocacy sectors. This collaboration resulted in the Respectful Maternity Care Charter: the Universal Rights of Childbearing Women and companion advocacy materials including a poster, brochure, and film. Grounded in human rights from internationally adopted declarations, these documents set the standard for Respectful Maternity Care and affirm it as every woman’s right. Promoting alignment among consumers and providers of health care about this framework of entitlement is a top priority. To eliminate disrespect and abuse during maternity care, the engagement of midwives and obstetricians is imperative. This presentation explores the conditions that may lead care providers to perpetrate abuses, and discusses their role as critical change agents through research, education, quality improvement, and community engagement. I171 PROMOTING WOMEN’S PARTICIPATION IN MATERNITY CARE: EXAMPLES FROM LEBANON T. Kabakian-Khasholian. Lebanon Women’s active involvement in maternity care and the responsiveness of different health care systems to women’s needs is a major deficiency encountered in different contexts around the world, both in developed and developing countries. The vast majority of systems providing maternity care around the world seek avoiding mortality by intervening excessively, thus leading to morbidity that could have been prevented. The alarming increase in cesarean births is one substantial example of these approaches. These maternity care models are characterized by their divergence from the scientific evidence indicating improved health outcomes of women-centered approaches, such as provision of information to women on different obstetrical procedures to facilitate women’s participation in the process of care by providing informed choices. Researchers of the Choices and Challenges in Changing Childbirth network in Lebanon have attempted influencing women’s perspectives and facilitating their inclusion in the maternal health care system through research and practice related activities. These were done by disseminating information on best practices to women and advocating for the adoption of evidence-based approaches in maternity care. These activities aimed at shaping women’s demand for a different model of maternity care that is based on scientific evidence and at encouraging a women-centered approach. This presentation will discuss these different activities as examples of promoting women’s participation in maternity care. I172 FIGO SAVING MOTHERS AND NEWBORNS PROJECT IN UGANDA F. Kaharuza, D. Zaake, S. Muwanguzi, O. Kakaire, J. Beyeza-Kashesya. Association of Obstetricians and Gynaecologists of Uganda (AOGU), Uganda Objectives: To contribute to reduction of maternal morality through increasing demand for and access to emergency obstetric and newborn care services in two rural districts in Uganda. Materials and Methods: Association of Obstetricians and Gynaecolgists of Uganda (AOGU) members developed partnerships with other professional associations to provide ALARM training and monthly onsite coaching and mentorship at six facilities; equipped the facilities, mobilized communities though training and support of 250 community health care workers Results: Facility births increased by 28% from baseline, facility based neonatal mortality reduced by 78%. Over 90 health care workers were trained in ALARM, and six health facilities were improved to provide at least five EmNOC signal functions. Eight management protocols were implemented by health workers while maternal death review committees were established at
I168 IJGO AUTHOR WORKSHOP: AN INSIDER’S GUIDE TO GETTING PUBLISHED T. Johnson1 , R. Adanu2 , V. Obama3 , V. Guinto4 , C. Sosa5 , C. Addington6 . 1 IJGO Editor-in-Chief ([email protected]); 2 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 3 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 4 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 5 Associate Editor: Contemporary Issues in Women’s Health ([email protected]); 6 IJGO Managing Editor (clare@figo.org) General overview of the session: An opportunity to learn more about how to maximize your chances of getting your research published from the IJGO Editorial team. From manuscript preparation, submission requirements, understanding the submission process and what’s happening at each stage, to top tips and insights from IJGO’s Editor and Associate Editors. I169 THE RESPECTFUL MATERNITY CARE CHARTER: A COLLABORATIVE WORK R.R. Jolivet Human rights are fundamental entitlements due to all people, recognized by societies and governments and enshrined in international declarations and conventions. A new charter, Respectful Maternity Care: the Universal Rights of Childbearing Women aims to address the problem of disrespect and abuse among women seeking maternity care and provide a platform for improvement by: • Raising awareness of childbearing women’s inclusion in guarantees of human rights recognized in internationally adopted standards and covenants; • Highlighting the connection between human rights language and key program issues in maternity care; • Increasing the capacity of maternal health advocates to participate in human rights processes; • Aligning childbearing women’s sense of entitlement to highquality maternity care with international human rights community standards; and • Providing a basis for holding maternal care systems and communities accountable to these rights. By drawing from established human rights instruments, the Charter demonstrates the legitimate place of maternal health rights within the broader context of human rights. Seven rights are included, corresponding to the seven categories of disrespect and abuse identified in the literature by Bowser and Hill (2010) in their review, “Exploring Evidence for Disrespect and Abuse in Facilitybased Childbirth: Report of a Landscape Analysis”. This charter was developed collaboratively by a multi-stakeholder group with expertise bridging research, educational, clinical, human rights, and advocacy perspectives. This presentation describes that process and methodology. I170 THE ROLE OF MIDWIVES & OBSTETRICIANS IN DELIVERING RESPECTFUL MATERNITY CARE R.R. Jolivet Evidence from 34 countries around the world documents physical assault, verbal insults, discrimination, abandonment, or detention without legal authority, perpetrated against childbearing women in maternal health facilities. Too often, women seeking maternity care receive treatment from their providers that ranges from disrespect to outright abuse, violating their basic human rights and the trust that is the foundation of the patient-provider relationship. Research suggests that fear of ill treatment can be a greater deterrent than cost or distance in the decision to seek facility-based maternity care. Furthermore, analysis of the available evidence suggests disrespect and abuse are associated with poor clinical
S203
quality of care, imposing undue risk on those women who seek skilled attendance in maternal health facilities. With support from USAID, the White Ribbon Alliance is working with partners from clinical, educational, research, human rights, and advocacy sectors. This collaboration resulted in the Respectful Maternity Care Charter: the Universal Rights of Childbearing Women and companion advocacy materials including a poster, brochure, and film. Grounded in human rights from internationally adopted declarations, these documents set the standard for Respectful Maternity Care and affirm it as every woman’s right. Promoting alignment among consumers and providers of health care about this framework of entitlement is a top priority. To eliminate disrespect and abuse during maternity care, the engagement of midwives and obstetricians is imperative. This presentation explores the conditions that may lead care providers to perpetrate abuses, and discusses their role as critical change agents through research, education, quality improvement, and community engagement. I171 PROMOTING WOMEN’S PARTICIPATION IN MATERNITY CARE: EXAMPLES FROM LEBANON T. Kabakian-Khasholian. Lebanon Women’s active involvement in maternity care and the responsiveness of different health care systems to women’s needs is a major deficiency encountered in different contexts around the world, both in developed and developing countries. The vast majority of systems providing maternity care around the world seek avoiding mortality by intervening excessively, thus leading to morbidity that could have been prevented. The alarming increase in cesarean births is one substantial example of these approaches. These maternity care models are characterized by their divergence from the scientific evidence indicating improved health outcomes of women-centered approaches, such as provision of information to women on different obstetrical procedures to facilitate women’s participation in the process of care by providing informed choices. Researchers of the Choices and Challenges in Changing Childbirth network in Lebanon have attempted influencing women’s perspectives and facilitating their inclusion in the maternal health care system through research and practice related activities. These were done by disseminating information on best practices to women and advocating for the adoption of evidence-based approaches in maternity care. These activities aimed at shaping women’s demand for a different model of maternity care that is based on scientific evidence and at encouraging a women-centered approach. This presentation will discuss these different activities as examples of promoting women’s participation in maternity care. I172 FIGO SAVING MOTHERS AND NEWBORNS PROJECT IN UGANDA F. Kaharuza, D. Zaake, S. Muwanguzi, O. Kakaire, J. Beyeza-Kashesya. Association of Obstetricians and Gynaecologists of Uganda (AOGU), Uganda Objectives: To contribute to reduction of maternal morality through increasing demand for and access to emergency obstetric and newborn care services in two rural districts in Uganda. Materials and Methods: Association of Obstetricians and Gynaecolgists of Uganda (AOGU) members developed partnerships with other professional associations to provide ALARM training and monthly onsite coaching and mentorship at six facilities; equipped the facilities, mobilized communities though training and support of 250 community health care workers Results: Facility births increased by 28% from baseline, facility based neonatal mortality reduced by 78%. Over 90 health care workers were trained in ALARM, and six health facilities were improved to provide at least five EmNOC signal functions. Eight management protocols were implemented by health workers while maternal death review committees were established at