The Heshima Project in Kenya is currently undertaking a three-pronged approach to addressing disrespect and abuse during facility based childbirth – at policy, facility and community levels.
Baseline findings from the Heshima project study area show that communities perceive non-dignified care as: use of harsh words that suggest rudeness and disrespect by facility staff; a lack of assistance for women in carrying a baby soon after he or she is born; providers reprimanding a client if she calls for help; facilities relying on cleaners and other staff without midwifery skills to assist in delivery; women asked to undress in front of others, with no gowns provided; and women having to share beds.
The following issues appear to influence whether women might give birth at home or in a health facility:
- Inadequate knowledge on individual and communities rights to quality care during childbirth in health facilities;
- Inadequate communication and linkage between the health facility management and providers and community members on issues related to facility based childbirth
- Limited opportunities for communities to seek redress if women are unhappy with the treatment they receive;
- Traditional beliefs, practices, customs and taboos make it difficult to discuss the issues around childbirth either with the health facility staff or any form of authority at community level.
The Heshima project is using existing community structures as it reaches out to communities living around the study facilities. In each target community, we bring together community watch groups, community health workers and community health extension workers. These meetings provide an arena for reviewing treaties promoting maternal health care that have been ratified by Kenya; discussing the specific Articles in Kenya’s new Constitution that provide for human dignity and right to life; and designing a work plan with the aim of educating the community on maternal health rights. Along the way, we provide training that will enable these key community members to not only disseminate critical information, but also to train others in their communities to do the same. Moreover, we work to foster partnerships between the community health strategy activities, community watch groups and facility management committees.
Together, the activities that are undertaken as part of the Heshima project seek to achieve the goals of enabling women to access the right to life as promulgated in the Constitution of Kenya and to have dignified health care during childbirth.
For more, click here for the full Respectful Maternity Care guest blog series.