Respectful maternity care in public health care facilities in Gujarat: A direct observation study

Hiral Raval; Tapasvi Puwar; Prakash Vaghela; Manshi Mankiwala; Apurva Kumar Pandya; Priya Kotwani

doi:10.4103/jfmpc.jfmpc_1934_20

Respectful maternity care in public health care facilities in Gujarat: A direct observation study

J Family Med Prim Care. 2021 Apr;10(4):1699-1705. doi: 10.4103/jfmpc.jfmpc_1934_20. Epub 2021 Apr 29.

Authors

Hiral Raval¹, Tapasvi Puwar¹, Prakash Vaghela², Manshi Mankiwala³, Apurva Kumar Pandya¹, Priya Kotwani⁴

Affiliations

¹ Indian Institute of Public Health Gandhinagar, Gujarat, India.
² Department of Health and Family Welfare, Government of Gujarat, Gujarat, India.
³ State Program Management Unit, National Health Mission, Government of Gujarat, Gujarat, India.
⁴ Parul Institute of Public Health, Parul University, Waghodia, Gujarat, India.

Abstract

Introduction: Respectful maternity care (RMC) is not only the marker of quality maternity care but also ensures the protection of basic human rights of every child-bearing woman. This paper discusses the assessment of RMC services during the intrapartum period at public health care facilities in Gujarat state.

Material and methods: A cross-sectional research design was used for the study. The data were collected from three different levels of public health facilities such as primary health center (PHC), community health center (CHC), and district hospital (DH) in one of the districts in Gujarat. A standardized tool developed by the United States Agency for International Development based on the RMC charter was used for data collection. A total of 41 pregnant women across three public health facilities were observed during intrapartum care.

Findings: Most women experienced disrespectful intrapartum care provided at the public health care facilities; however, at-least two performance standards of the RMC charter were met during intrapartum care at each public health care facility. Comparatively, the PHC demonstrated higher RMC performance compliance than DH and the CHC. Most often violations of RMC standards included beneficiaries were not greeted, privacy not maintained, they were not encouraged to ask questions, and support not provided during labor.

Conclusion: Respectful maternity care is evidently not practiced in public health care facilities. Designing comprehensive behavioral training on RMC, especially for primary, secondary, and tertiary care physicians and nursing staff can improve the adaption of RMC standards in respective public health care facilities. Positive experiences of intrapartum care can potentially improve the uptake of maternal care facilities. Further research is needed to understand local contextual factors, social norms, and patient-provider interactions.

Keywords: India; intrapartum care; public health care facilities; quality of care; respectful maternity care.