Respectful midwifery care in Malawi: A human rights-based approach

Abstract

Background: A priority in Malawi over the past 15 years has been to improve women's access to skilled birth attendants by training and educating more midwives, and encouraging women to deliver in health facilities. However, women's choices in accessing skilled birth attendance have been negatively impacted by the treatment they receive from their care provider. Aims: To design and pilot a training module for clinical midwives in the promotion of respectful maternity care, and to demonstrate to participants the link between human rights and maternal health care, showing how a human rights based approach may improve the experiences of patients and care providers. Methods: The training programme was devised jointly by an interdisciplinary team from midwifery and law. Relevant materials were devised and grafted onto the programme already delivered in Malawi by the Scottish team under the auspices of the Scottish Universities and the Malawian Ministry of Health partnership. These materials were then piloted in Malawi with a group of 40 midwives and managers. The materials were delivered by presentation, discussion and case studies. Findings: Participants were invited to provide anonymised free text quotes on completion of the training. The data gathered indicated an appetite for learning about respectful maternity care. Cognisance has been given to the feedback received from the facilitators. Conclusions: The success of the pilot has led to funding being secured for a larger trial, where the impact of the approach may be more comprehensively measured.