An awareness-raising framework for global health networks: lessons learned from a qualitative case study in respectful maternity care

Abstract

BackgroundThe increase in global health networks as mechanisms for improving health and affecting social change has been recognized as a key component of the global health landscape today. To successfully raise awareness of shared causes, global health networks need tools to help them plan successful campaigns and evaluate the impact of their work, as well as to coordinate and reinforce each other’s efforts. One global health network, the Respectful Maternity Care (RMC) Global Council, can be credited with raising the profile of the issues of disrespect and abuse (D&A) in childbirth and the need for RMC within global maternal health. We set out to learn from the work of the RMC Global Council and the RMC movement at large to develop a tool—a framework for planning and evaluating awareness-raising efforts—useful for networks focused on global health and human rights.MethodsWe reviewed the literature for theoretical models on awareness raising and, finding a lack of appropriate tools, developed a new, draft framework using components of the Framework for Effective Campaigns, the SpitFire SmartChart 3.0, and Network Theory. We conducted semi-structured interviews with members of the RMC Global Council to validate the draft framework and identify any additional strategies or tactics that were used during their efforts to raise awareness of D&A and RMC. We also interviewed “influenced” individuals to validate inputs from the influencers and determine the key documents, events, individuals, and organizations that made the greatest contribution to the increased awareness of D&A/RMC. Data were analyzed using deductive and inductive qualitative research methods.ResultsThe validated awareness-raising framework includes five strategies that characterize a successful awareness-raising effort. Each strategy has a set of tactics that can operationalize those strategies. Each tactic is classified as essential, helpful, or variable based on the number of key informants who utilized it.ConclusionThis case study offers an example of how global health networks can create a movement that effects change at global and local levels by providing an empirically-grounded framework to help plan, coordinate, and evaluate future campaigns designed to raise awareness and create momentum in global health, human rights, and quality of care.Electronic supplementary materialThe online version of this article (10.1186/s12978-018-0662-9) contains supplementary material, which is available to authorized users.

Factors associated with unmet fertility desire and perceptions of ideal family size among women in Bangladesh: Insights from a nationwide Demographic and Health Survey

“…Therefore, further qualitative research is recommended to unravel the reasons behind this finding. As per earlier studies, we also observed that the wealth index is a crucial factor for unmet fertility needs, as unmet needs are lower for the wealthiest quintile households [28][29][30][31]33,38]. A positive association between health and wealth status has been well established, as mothers from the poorest households have limited access to health facilities and mass media; therefore, they are less likely to be informed of the detrimental effect of excess fertility.…”

“…The use of contraceptive methods is a significant factor of unmet need of fertility desire in our study that is related to religious beliefs [26]. Women often choose to prevent pregnancy by using various contraceptive methods for either have a birth interval or to stop childbearing; however, contraceptive discontinuation is very common in developing countries [30,31,33]. Studies observed that the various reasons for limiting contraceptive use include contraception failure, actual or perceived problems with the contraception method, lack of information, religious conservatism, husband's reluctance, and various supply-side factors (e.g., family planning kit, health education) that strongly contribute to an unplanned pregnancy and unwanted births [8,34].…”

“…The present study also reveals that there is a significant relationship between the unmet need for fertility and the age and educational status of mothers. The positive relationship between the level of education and public health awareness is well established [9,31,33,35]. Educated people have more knowledge on various health issues including self-care with selfdependency, the benefits of maternal care, and better knowledge regarding the adverse effects of pregnancy-related complications and associated costs; as such, they can lead households in a planned manner [36,37].…”

Exploring midwives’ understanding of respectful maternal care in Kumasi, Ghana: Qualitative inquiry

“…RMC refers to "care organized for and provided to all women in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labour and childbirth" [12]. RMC has been measured through systematic labour observations, cross-sectional surveys using standardized questionnaires as well as through in-depth interviews with maternity care providers and postpartum women [8,[13][14][15][16]. In these studies [8,[13][14][15][16], the RMC metrics focus on childbirth experiences in the following domains: physical, verbal, and psychological abuse, discriminatory care, vaginal examinations, companionship, pain relief, choice of alternative birthing position, and health system drivers.…”

Mass media campaigns to reduce unnecessary caesarean sections: a systematic review

“…Reviews have shown the effectiveness of mass media campaigns targeted at reducing unhealthy habits or promoting healthy behaviours such as breast feeding or family planning, among others 21–27. However, significant changes in behaviour can be achieved only when campaigns are well designed and carried out at sufficient scale and intensity 21 28–36…”