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Opinion - Respectful maternity care matters

2020-11-13  Staff Reporter

Opinion - Respectful maternity care matters

All individuals irrespective of their age, gender, race or social standing have the right to health and to access healthcare services. The right to health means that everyone is entitled to have control over their own health and body, including the access to sexual and reproductive information, rights and services. 

In Namibia, more than 85% of women and pregnant women have access to facilities offering sexual, reproductive maternal, child healthcare services, and these services are rendered by skilled practitioners who are mostly, midwives. Evidence indicates that every pregnancy faces a risk of complication, however, it is not possible to predict which pregnant woman will develop obstetric complications. 

It is important to note that about 87% of pregnant women in Namibia attend antenatal care and or deliver their babies in a health facility with the presence of a skilled birth attendant, in many instances, midwives. Having access to a healthcare facility and the presence of a skilled midwife before and during pregnancy, labour and postpartum was found to have a significant reduction of maternal morbidity and mortality. 
While skilled and supported midwives are the right cadres to take care of women; midwives are also trained to prevent complications through early detection, diagnosis, treatment and referral, which improves the overall quality of maternal care. 

Without doubt, there is high value attached to motherhood and women’s experiences during pregnancy and childbirth, and this has an effect on their healthcare seeking behaviour and expectations for subsequent pregnancies. Imagine the personal treatment you would expect from the midwife entrusted to help you or the woman you love give birth. 
Ideally, women and midwives should develop a relationship characterised by gentle, effective communication, support, kindness and respect. Respectful maternity care refers to care organized for and provided to all women in a manner that maintains their dignity, confidentiality and privacy while ensuring the freedom from harm and ill treatment. 
Whereas respectful maternity care is a universal human right that is due to every childbearing woman in every health system around the world, there has been a growing global evidence of disrespect and abuse of women during pregnancy and childbirth and Namibia is no exception. 

Credit goes to the government of the Republic of Namibia for allowing the freedom of press and hence the continuous interest of media personnel to report on issues affecting the general public. Over the years, many local news reporters and media houses have been running and publishing stories about poor quality healthcare and client mistreatment by healthcare workers. Similarly, the Namibia 2013 presidential commission of inquiry report into the activities and operations of the Ministry of Health and Social Services found that the attitudes and conduct of many healthcare workers had a negative impact on healthcare. 
In addition, the report also highlighted that, the status of maternal, newborn child and adolescent health was very poor and this was as a result of negative attitudes and sometimes system failures. 

Some factors such as normalisation of disrespect and abuse during pregnancy and childbirth, lack of women autonomy and empowerment, lack of community engagement and financial barriers contribute to the disrespect and abuse of women.
In 2014, the World Health Organisation (WHO) released a statement calling for the prevention and elimination of disrespect and abuse during pregnancy and childbirth, stating “every woman has the right to the highest attainable standard of health, including the right to dignified, respectful care during pregnancy and childbirth.”

In the same vein, WHO also called for the mobilisation of governments, programmers, researchers, advocates and communities to support respectful maternity care. The White Ribbon Alliance which envisions a world where the rights of all women to be safe and healthy before, during and after childbirth has developed the respectful maternity care charter of rights which demonstrates the legitimate place of maternal health rights in the broader context of human rights. 

These rights are; 1. Every woman has the right to be free from harm and ill treatment. 2. Every woman has the right to information, informed consent and refusal, and respect for her choices and preferences including companionship during maternity care. 3. Every woman has the right to privacy and confidentiality. 4. Every woman has the right to be treated with dignity and respect. 5. Every woman has the right to equality, freedom from discrimination and equitable care. 6. Every woman has the right to healthcare and to the highest attainable level of health. 7. Every woman has the right to liberty, autonomy, self-determination and freedom from coercion. It is thus imperative that we employ a comprehensive approach that will benefit women, their new-borns and families; the healthcare providers and the communities they serve, by speaking out and demand respectful care, and thus making it safer for women to demand the type of maternity care they need.
As a nation, commitments to respectful maternity care will be realised when there are changes to policy and when there is pressure to hold the government responsible, answerable and accountable. 

The Ministry of Health and Social Services has been engaged and making efforts to create awareness about respectful maternity care. 
Thus in order to support the ministry’s effort, individuals, civil society organisations, partners and media houses should take a collective responsibility by holding hands and take the stand to help spread the message and create awareness about respectful maternity care.
Let us start and continue to educate and inform women of their rights, encourage women to speak out and about any form of disrespect and abuse, motivate women to share their stories to national audiences. 

All these efforts will in turn enable and inform policy change and understanding of systematic improvements that are needed within the healthcare systems to uphold a culture of respectful care.  
Respectful maternity care is a critical component, which affects the outcome of women and their new-borns. Therefore, your interest in taking an active part in creating awareness about respectful maternity care at any level means you care for and about women and their families. 
Whereas, if midwives embrace the concept of respectful maternity care, there is an increase in facility births which results in positive pregnancy experience and outcomes, and thus improving global maternal health!

2020-11-13  Staff Reporter

Tags: Khomas
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