Promoting Supportive and Respectful Maternity Care in Public Health Facilities in Sindh, Pakistan: A Theory-Informed Health System Intervention

Avan, Bilal Iqbal; Hameed, Waqas; Khan, Bushra Tayyaba; Asim, Muhammad; Saleem, Sarah; Siddiqi, Sameen

doi:10.9745/ghsp-d-22-00513

Cited by 4 publications

(3 citation statements)

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“… 17 Details of the intervention design, implementation, and effectiveness have been previously published. 12 , 13 A member of the existing clinical maternity team—identified as a focal person called the “mental health first aider”—was made responsible for overseeing the implementation of S-RMC components in routine intrapartum care.…”

Section: The S-rmc Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…12 The intervention was implemented at public health facilities in southern Sindh, Pakistan, and the broader effect of the intervention on women's experiences of mistreatment has been reported elsewhere. 13 This article draws lessons from implementing the S-RMC intervention at 6 public health facilities. Generally, information is limited on service providers' experiences of and reactions to S-RMC interventions and related factors affecting implementation.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the Mechanisms of Change in the Supportive and Respectful Maternity Care Intervention in Sindh, Pakistan: Provider Perspectives

Avan,

Hameed,

Khan

et al. 2023

Glob Health Sci Pract

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Section: The S-rmc Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding the Mechanisms of Change in the Supportive and Respectful Maternity Care Intervention in Sindh, Pakistan: Provider Perspectives

Avan,

Hameed,

Khan

et al. 2023

Glob Health Sci Pract

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Optimising Perinatal Mental Health: Implementation Framework for Integrating Interventions into Primary Healthcare Systems

Hameed,

Katiyar,

Avan

2024

Mental Health & Prevention

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The Role of Birth Companionship in Women’s Experiences of Mistreatment during Childbirth and Postpartum Depression

Hameed,

Khan,

Avan

2024

Preprint

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Introduction Birth companionship during facility-based childbirth has been recommended by the World Health Organization to improve maternal and newborn outcomes. However, limited evidence exists on how companionship affects women's experiences of mistreatment during childbirth and their mental health. Objectives To assess the characteristics of birth companionship during intrapartum care and examine its associations with women's experiences of mistreatment and postpartum anxiety and depression. Methods We analysed cross-sectional data on 314 women who gave birth in six public health facilities in rural Sindh, Pakistan. Women were interviewed 42 days postpartum about their childbirth experiences and postpartum anxiety and depression. Multivariable regression models were used to examine associations between birth companionship, mistreatment, and postpartum anxiety/depression. Path analysis explored whether mistreatment mediated the relationship between companionship and postpartum anxiety and depression. Results Most women (83.1%) had a full-time companion in the labor room, with in-laws (44.6%) being the most common, followed by family members (26.1%) and friends (15.0%). Higher levels of companion support were associated with lower levels of mistreatment, particularly regarding non-confidential care, lack of supportive care, and ineffective communication. Women receiving low companion support were 2.86 times more likely to experience postpartum anxiety and depression compared to those receiving high support. Informational support emerged as the strongest protective factor against both mistreatment and postpartum anxiety/depression. Path analysis revealed that the effect of companion support on postpartum mental health was mediated by experiences of mistreatment during childbirth. Conclusion Birth companionship, especially informational support, plays a crucial role in reducing mistreatment during childbirth and improving maternal mental health outcomes. These findings underscore the need for supportive policies and health system interventions that actively encourage the engagement of companions from a woman's personal network during labor and childbirth. Future research should explore strategies to optimize the role of birth companions in promoting respectful maternity care and maternal well-being.

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Promoting Supportive and Respectful Maternity Care in Public Health Facilities in Sindh, Pakistan: A Theory-Informed Health System Intervention

Abstract: Mistreatment during childbirth is prevalent in many LMICs. The authors piloted a health system intervention to build maternity teams’ capacity to provide inclusive, supportive, and respectful maternity care to women during childbirth.

Cited by 4 publications

References 28 publications

Understanding the Mechanisms of Change in the Supportive and Respectful Maternity Care Intervention in Sindh, Pakistan: Provider Perspectives

Understanding the Mechanisms of Change in the Supportive and Respectful Maternity Care Intervention in Sindh, Pakistan: Provider Perspectives

Optimising Perinatal Mental Health: Implementation Framework for Integrating Interventions into Primary Healthcare Systems

The Role of Birth Companionship in Women’s Experiences of Mistreatment during Childbirth and Postpartum Depression

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