Pathways to respectful maternity care in Malawi: a participatory action research project.

Prince Leopold Institute for Tropical Medicine
Organization Location: 
Antwerp, Belgium

In Malawi only 71% of births are attended by a skilled birth attendant. Disrespectful treatment of women in maternity facilities represents one of the most important barriers to accessing facility based maternity care. This action research project will support delivery of respectful maternity care (RMC) by enhancing the capacity of midwives to provide RMC. In collaboration with service users and midwives, it will identify barriers as well as factors that enable provision of RMC and develop, implement and evaluate strategies to support delivery of RMC. By enhancing provision of RMC it will improve women's experiences of facility based care and thus increase their uptake of maternity services. Rather than providing additional resources, this project will maximize access to existing facilities for women, in order to make best use of limited resources. It is innovative in its focus on how rather than what care is provided, and on interpersonal rather than financial / geographic barriers to access. Its approach is further innovative in that it involves full participation of service users and providers in problem analysis, design, implementation and evaluation of solutions, which will ensure that these are rooted in the local context. The project will thereby account for the complexity inherent in problems of care quality and the local actors’ understandings and interpretations – both vital but traditionally overlooked ingredients in successful behaviour change interventions.

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