Respectful Maternal Care

Since the Bowser and Hill Landscape Analysis was commissioned in 2010, much has been done to address disrespect and abuse in birthing facilities and to develop, test, and implement interventions and approaches to promote respectful maternal care (RMC) (see the Timeline of Key Events for major milestones). Implementation Science Collaborative (ISC) partners have engaged researchers, implementers, and policy experts from Africa and the U.S. to generate more evidence on promising approaches, analysis and consultation around RMC terms and framing, improved packaging of evidence and knowledge products, and informed indicator development for routine monitoring and evaluation of RMC.

ISC RMC Activity Overview Brief

General Background: Disrespect & Abuse/RMC

In 2022, the ISC welcomed more than 300 people from 50+ countries for a webinar exploring evidence, experiences and perspectives on approaches and routine monitoring and evaluation for respectful maternal care in Africa. It was co-hosted by the East, Central, and Southern Africa Health Community and the University of California San Francisco.

Catalyzing Change

Informing Policy & Practice

The Honorable Minister of Health of Tanzania, Ummy Mwalimu, speaks about Respectful Care at the ECSA-HC Health Minister’s Conference in March 2018. To her right are panelists Dr. Mary Mwanyika Sando of AAPH and Dr. Dilys Walker of UCSF. Learn more about the resolution that was passed as a result below.

In the past decade, policy advocacy efforts have resulted in the incorporation of respectful care in normative global guidelines and national policies, and several countries have enacted legislation to protect women during facility-based delivery. Thanks to these efforts, the issue of respectful care has become more mainstream in the scientific, medical, and policymaking communities and among the general public, as evidenced by the publication of numerous articles and reports.

Implementation Science Collaborative (ISC) partners have helped influence the respectful maternal care (RMC) agenda and action. This was achieved through deliberate stakeholder engagement and extending the reach and accessibility of RMC evidence and tools through the development of knowledge hubs, repositories, webinars, and publications and additional dissemination of information.

How has implementation science influenced change?

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ISC partners participated in consultations on disrespect and abuse, which helped inform the WHO Statement on the Prevention and Elimination of Disrespect and Abuse During Facility-Based Childbirth (2014). Implementation Research Studies in East Africa informed the WHO’s global mistreatment research effort. ISC partners continue to actively engage in the RMC Global Council, community of practice hosted by the White Ribbon Alliance, and support USAID efforts to advance RMC within the agency and beyond.

East, Central Southern Africa Health Community (ECSA-HC) began hosting a series of consultations in 2016, which paved the way for a ministerial resolution on RMC in 2018. The resolution represents tangible member state recognition of RMC as a priority as well as the need to apply implementation science approaches to addressing disrespect and abuse and the advancement of respectful maternal care. ECSA-HC remains a key policy platform partner in the ISC.

In addition to the influence the initial implementation research had in Kenya (Heshima) and Tanzania (Staha), there have been additional policy and strategy advancements in both countries, and we continue to support efforts in Tanzania. Tanzania most recently adopted the National Guideline for Gender and Respectful Care Mainstreaming and Integration Across RMNCAH services in Tanzania.