Summary

Around the world, women who give birth in health facilities often face undignified conditions and poor quality of care. Causes of mistreatment are often complex and multifaceted, involving individual and health system level constraints such as health provider workload, infrastructure and supply challenges, gender and socio-cultural dynamics, and poor health system management. Negative care environments not only affect the recipients of care, but also impact the experience of healthcare providers.

The Bowser and Hill Landscape Analysis commissioned by URC through the Translating Research into Action (TRAction) Project in 2010 identified seven categories of disrespect and abuse (D&A) related to facility-based childbirth, thus laying the groundwork for the modern RMC movement. Much of the early learning was informed by TRAction implementation research studies led by Columbia University and Population Council, which included investigating prevalence and drivers of D&A and developing and testing approaches to advance RMC in Tanzania and Kenya. Paired with advocacy efforts by the White Ribbon Alliance and the Global Respectful Maternity Care Council, the need to mitigate D&A and ensure respectful care has gained momentum over the last decade. The HEARD Project builds on this momentum to bring more evidence to bear on solutions to advance respectful care in low- and middle-income countries.