A call for collaboration on respectful, person-centered health care in family planning and maternal health

Abstract

BackgroundStriking tales of people judged, disrespected, or abused in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services are commonly exchanged among friends and families throughout the world while remaining sorely under-addressed in global health. Disrespect and abuse of individuals and providers in health services across the RMNCAH continuum must be stopped through collaborative, multi-tiered efforts.Call for collaborationA new focus on health care quality in the Sustainable Development Goals offers an opportunity to seriously reexamine user experiences and their impact on health care utilization. The new framework provides an opening to redress the insidious problem of negative interactions with care across the RMNCAH services continuum and redraft the blueprint for service delivery and performance measurement, placing individuals and their needs at the center. Both the maternal health and family planning fields are at a turning point in their histories of defining and addressing individuals’ experiences of care. In this commentary, we review these histories and the current state-of-the-art in both fields. Though the approaches and language in each sub-field vary, person-centered care principles related to the essential role of individuals’ preferences, needs and values, and the importance of informed decision-making, respect, privacy and confidentiality, and non-discrimination, are integral to all. Promoting respectful, person-centered care also requires recognizing the factors that lead to poor treatment of clients, including gender norms and unsupportive working conditions for providers. Lessons can be learned from innovative efforts across the continuum to support health care providers to provide respectful, person-centered care.ConclusionEfforts in the maternal health and family planning fields to define respectful, person-centered care provide a useful foundation from which to connect across the continuum of RMNCAH services. Now is the time to creatively work together to develop new approaches for promoting respectful treatment of individuals in all RMNCAH services.

Respectful maternity care and associated factors among women who delivered at Harar hospitals, eastern Ethiopia: a cross-sectional study

“…Promoting institutional delivery without the implementation of RMC may paradoxically increase maternal mortality [26]. Reevaluating women's childbirth experience is indispensable to fascinate women with facility delivery [27,28]. Despite many published evidence about the individual cases of D&A, there is a scantiness of proof concerning the prevalence estimate of RMC in facility-based childbirth; particularly there is a scarceness of evidence in Eastern Ethiopia.…”

Development and Validation of the Client‐Reported Quality of Contraceptive Counseling Scale to Measure Quality and Fulfillment of Rights in Family Planning Programs

“…This interaction is important both in terms of the information exchanged and the interpersonal relationship (Bruce ; Jain and Hardee ). Members of our team recently synthesized best practices in contraceptive counseling, the health communication literature, and human rights guidelines to define a new Quality in Contraceptive Counseling (QCC) Framework (Figure ) (Holt, Dehlendorf, and Langer ). This framework displays at a more granular level than general quality of care frameworks what an ideal interaction between a client and a provider entails.…”

“…Directly probing for negative experiences—as is now being done widely in the maternal health field (Harris, Reichenbach, and Hardee 2016; Holt, Caglia, Peca et al. ; Sando et al. )—would help align measurement tools with the new focus on rights‐based service delivery.…”

Effect of a smartphone intervention on self‐managed medication abortion experiences among safe‐abortion hotline clients in Indonesia: A randomized controlled trial

“…Prior literature has documented limitations of relying on measures of satisfaction to evaluate client's experiences with abortion, finding little variation in reported levels of satisfaction even when components of the abortion experience differ . Less common are studies to measure more nuanced person‐centered indicators of the quality of abortion care, such as the primary outcomes in this study (support, confidence, preparedness), though calls for focusing on person‐centered care in family planning and abortion are increasing . Given that levels of preparedness, confidence, and feelings of support were all extremely high among both control and intervention arms, our null findings are unsurprising and likely speak to the high‐quality, evidence‐based, comprehensive, and supportive abortion counseling received by all Samsara clients.…”

“…[17][18][19] Less common are studies to measure more nuanced personcentered indicators of the quality of abortion care, such as the primary outcomes in this study (support, confidence, preparedness), though calls for focusing on person-centered care in family planning and abortion are increasing. [20][21][22] Given that levels of preparedness, confidence, and feelings of support were all extremely high among both control and context suggest that women may not consider their abortion process to be complete until after confirmation via urine pregnancy test; thus, the relatively high proportion of participants who report being "unsure" about whether their abortion was complete may be reflective of the fact that their follow-up questionnaire was completed before taking a pregnancy test.…”