This post is in commemoration of Human Rights Day and the importance of the last 16 Days of Activism Against Gender Violence, which started off with the International Day for the Elimination of Violence against Women. Disrespect and abuse in maternity care is an institutionalized form of gender violence. In addition, please find a round-up of recent news addressing human rights violations and gender violence at the end of this post.
The fact that nearly one in three women globally has experienced intimate partner violence, a form of gender-based violence (GBV), is widely known. But can you easily name a situation where GBV occurs in the healthcare system?
GBV is a worldwide problem that occurs in many contexts and in many forms including sexual violence, physical and verbal abuse, and cultural practices that harm women. The 16 Days of Activism against Gender Based Violence campaign, which launched on November 25th, puts this serious issue under the international spotlight.
Current discourses on GBV, though they acknowledge that GBV occurs in many different contexts, rarely address GBV in health care settings. Disrespect and abuse during childbirth not only echoes other forms of GBV, but also contributes to women’s underutilization of skilled delivery services, which can negatively impact women’s health. Promoting respectful and dignified maternal health care is central to upholding human rights and improving the provision of women’s healthcare. Incorporating discussions on respectful maternal care into the global GBV dialogue is necessary for making this important issue a global priority.
Around the world, women experience a range of disrespectful and abusive behavior at the hands of the health system: including, physical abuse, disregard for privacy, and unfair requests for payment. Research from TRAction-funded projects on respectful maternal care reveals that this disrespect and abuse—as with other forms of GBV—is an extension of existing structural inequalities. For example, these disrespectful, abusive behaviors are often a byproduct of stressful working conditions, as (often female) healthcare workers are overworked in a health system that is frequently understaffed and strained for resources. The TRAction-funded STAHA project in Tanzania has implemented interventions to help healthcare workers cope with stress, and the Heshima Project in Kenya has adopted a model of disrespect and abuse that takes into account the individual, structural, and policy levels, suggesting that effective interventions to decrease disrespect and abuse must be systemic.
Recently, TRAction’s implementing partners at Columbia University published a commentary in Lancet’s Midwifery Series, in which they emphasize that disrespect and abuse does not occur only at the hands of healthcare providers, but also by the health system itself. In other words, the existence of disrespect and abuse is a symptom of a “health system in crisis.” While it is imperative that we consider women’s perspectives and experiences, tackling GBV in all its forms will require us to go beyond individual-level interventions to address the structural contexts and power inequalities that enable GBV and disrespect and abuse during childbirth to occur in the first place.
Gender equality is clearly key to international efforts to achieve sustainable development goals and situating respectful maternity care within the broader global dialogue on GBV will help us in these efforts.
This post originally appeared on the USAID TRAction Blog.