Respectful maternity care in public health care facilities in Gujarat

Abstract

Introduction: Respectful maternity care (RMC) is not only the marker of quality maternity care but also ensures the protection of basic human rights of every child-bearing woman. This paper discusses the assessment of RMC services during the intrapartum period at public health care facilities in Gujarat state. Material and Methods: A cross-sectional research design was used for the study. The data were collected from three different levels of public health facilities such as primary health center (PHC), community health center (CHC), and district hospital (DH) in one of the districts in Gujarat. A standardized tool developed by the United States Agency for International Development based on the RMC charter was used for data collection. A total of 41 pregnant women across three public health facilities were observed during intrapartum care. Findings: Most women experienced disrespectful intrapartum care provided at the public health care facilities; however, at-least two performance standards of the RMC charter were met during intrapartum care at each public health care facility. Comparatively, the PHC demonstrated higher RMC performance compliance than DH and the CHC. Most often violations of RMC standards included beneficiaries were not greeted, privacy not maintained, they were not encouraged to ask questions, and support not provided during labor. Conclusion: Respectful maternity care is evidently not practiced in public health care facilities. Designing comprehensive behavioral training on RMC, especially for primary, secondary, and tertiary care physicians and nursing staff can improve the adaption of RMC standards in respective public health care facilities. Positive experiences of intrapartum care can potentially improve the uptake of maternal care facilities. Further research is needed to understand local contextual factors, social norms, and patient-provider interactions.

Respectful maternity care during childbirth: Experiences and observation among mothers in a tertiary-care institute in Manipur

“…This finding is largely consistent with those from other studies on disrespectful care in maternity services. [ 27 28 29 30 31 ] In a study by Bhattacharya S et al , the proportion of women who experienced any disrespect or abuse was only 28.8%. Physical abuse was 55 (13.4%) and shouting/scolding 71 (17.3)[ 8 ], and in another study, physical abuse was 84 (5%).…”

“It’s like asking for a necktie when you don’t have underwear”: Discourses on patient rights in southern Karnataka, India

“…India had endorsed human rights framework constitutionally [50]. Nonetheless, there are several research studies and media reports from India on patient rights violations in health facilities such as abuse, disrespectful care, unethical practices by the care-providers, denial of health care, exorbitant charging of the patients by the private hospitals, discrimination of care-seeking individuals based on their caste and other socio-economic precarities [51][52][53][54][55][56][57][58][59]. Notwithstanding with these disturbing findings on patient rights violations, the discontent and frustration between patients, health care-providers and health care systems is expressed in the form of violence against health careproviders and facilities [60][61][62].…”

Intrapartum respectful maternity care practices and its barriers in Eastern India

“…[ 3 ] Despite the international laws upholding the pregnant women’s right to respectful maternal care (RMC), there are numerous reports of abuse, mistreatment, and neglect of the pregnant woman during the entire pregnancy cycle, especially in low- and middle-income countries (LMIC). [ 4 5 ] Such treatment violates women’s rights to RMC, threatens their rights to life, health, bodily integrity, and freedom from discrimination, and deters them from seeking evidence-based institutional care. [ 6 ] A systematic review of obstetric violence in India indicates at least one instance of mistreatment.…”