Intrapartum respectful maternity care practices and its barriers in Eastern India

Smitha, M V; Yadav, Pooja; Jacob, Jaison; Begum, Jasmina

doi:10.4103/jfmpc.jfmpc_1032_22

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Instead, they view such actions as a form of assistance or ‘help’ beneficial to the newborn, justifying their behavior. Similarly, in India, wrong perspectives on obstetric violence were identified as a major driver of these abuses within healthcare facilities ( 53 ). Hence, there is a crucial need for studies to specifically target the healthcare team, addressing and rectifying these misconceptions.…”

Section: Discussionmentioning

confidence: 99%

Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality

Yalley,

Jarašiūnaitė-Fedosejeva,

Kömürcü-Akik

et al. 2024

Front. Public Health

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BackgroundThe mistreatment and abuse of women during childbirth have been recognized as a major global health challenge, impeding facility-based delivery and contributing to the high maternal mortalities globally. The World Health Organization has specifically called for interventions to deal with obstetric violence. This scoping review consolidates the existing literature on interventions aimed at reducing obstetric violence and synthesizes existing knowledge on their impact in promoting respectful maternity care.MethodologyThirteen electronic databases were searched for relevant articles from January 2001 to March 2023. A total of 863 records were identified, and 72 full-text articles were retrieved for further screening. The review includes 16 studies, particularly from low- and middle-income countries, with interventions implemented at medical facilities and involving both women and healthcare providers. Eight of the studies were quantitative, three were qualitative and five used a mixed-methods approach.FindingsThe results reveal a promising trend in reducing obstetric violence through various interventions. Ten different types of interventions were identified, highlighting strategies to improve the quality of maternity care and enhance patient-centered care. Improved patient-provider communication skills, increased privacy measures, and reduced abuse and mistreatment emerged as common themes. Enhanced communication skills, including open discussions and the right to be informed, were crucial in reducing obstetric violence. Privacy measures, such as separate rooms, curtains, and birth companions effectively decreased incidents of non-confidential care. General abuse and mistreatment, including physical abuse and neglect, were also reduced, leading to improved perceptions of respectful care during childbirth.ConclusionOverall, the interventions had a favorable impact on obstetric violence reduction and women’s childbirth experiences. However, despite promising results, obstetric violence remains prevalent worldwide, necessitating more efforts to implement effective interventions. To the best of our knowledge, this is the first scoping review on obstetric violence interventions, providing a comprehensive overview of the state of the art. We suggest that further research is needed to explore new interventions, particularly gender-sensitive interventions, to contribute to a growing body of knowledge on the prevention of obstetric violence.

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Section: Discussionmentioning

confidence: 99%

Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality

Yalley,

Jarašiūnaitė-Fedosejeva,

Kömürcü-Akik

et al. 2024

Front. Public Health

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Improving management of first and second stages of labour in low- and middle-income countries

Hofmeyr,

Moreri-Ntshabele,

Qureshi

et al. 2024

Best Practice & Research Clinical Obstetrics & Gynaecol

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Appraising LaQshya’s potential in measuring quality of care for mothers and newborns: a comprehensive review of India’s Labor Room Quality Improvement Initiative

Singh,

Hasan,

Sharma

et al. 2024

BMC Pregnancy Childbirth

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Background Poor intrapartum care in India contributes to high maternal and newborn mortality. India’s Labor Room Quality Improvement Initiative (LaQshya) launched in 2017, aims to improve intrapartum care by minimizing complications, enforcing protocols, and promoting respectful maternity care (RMC). However, limited studies pose a challenge to fully examine its potential to assess quality of maternal and newborn care. This study aims to bridge this knowledge gap and reviews LaQshya’s ability to assess maternal and newborn care quality. Findings will guide modifications for enhancing LaQshya’s effectiveness. Methods We reviewed LaQshya’s ability to assess the quality of care through a two-step approach: a comprehensive descriptive analysis using document reviews to highlight program attributes, enablers, and challenges affecting LaQshya’s quality assessment capability, and a comparison of its measurement parameters with the 352 quality measures outlined in the WHO Standards for Maternal and Newborn Care. Comparing LaQshya with WHO standards offers insights into how its measurement criteria align with global standards for assessing maternity and newborn care quality. Results LaQshya utilizes several proven catalysts to enhance and measure quality- institutional structures, empirical measures, external validation, certification, and performance incentives for high-quality care. The program also embodies contemporary methods like quality circles, rapid improvement cycles, ongoing facility training, and plan-do-check, and act (PDCA) strategies for sustained quality enhancement. Key drivers of LaQshya’s assessment are- leadership, staff mentoring, digital infrastructure and stakeholder engagement from certified facilities. However, governance issues, understaffing, unclear directives, competency gaps, staff reluctance towards new quality improvement approaches inhibit the program, and its capacity to enhance quality of care. LaQshya addresses 76% of WHO’s 352 quality measures for maternal and newborn care but lacks comprehensive assessment of crucial elements: harmful labor practices, mistreatment of mothers or newborns, childbirth support, and effective clinical leadership and supervision. Conclusion LaQshya is a powerful model for evaluating quality of care, surpassing other global assessment tools. To achieve its maximum potential, we suggest strengthening district governance structures and offering tailored training programs for RMC and other new quality processes. Furthermore, expanding its quality measurement metrics to effectively assess provider accountability, patient outcomes, rights, staff supervision, and health facility leadership will increase its ability to assess quality improvements.

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Intrapartum respectful maternity care practices and its barriers in Eastern India

Cited by 3 publications

References 33 publications

Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality

Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality

Improving management of first and second stages of labour in low- and middle-income countries

Appraising LaQshya’s potential in measuring quality of care for mothers and newborns: a comprehensive review of India’s Labor Room Quality Improvement Initiative

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