Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
Background: The decision to seek facility-based birth care is fundamental to addressing global maternal morbidity and mortality. Kind and respectful maternity care is an important factor in a mother’s decision making process. Integrating kind and respectful care into national or international scale-up of provider training programs is challenging and sensitive, given the importance of local culture, traditions, and norms. Early in PRONTO’s experience with in-situ simulation, trainers recognized both the power, and risk, of addressing examples of both kind and disrespectful care during facilitated video-guided simulation debriefs.
Methods: The PRONTO team developed a series of interactive activities, highly realistic simulations, and facilitation techniques that promote provider self-reflection on topics related to kind and respectful care during childbirth. Activities are designed to increase awareness of individual and group values and their impact on care norms. Facilitator training includes a module on cultural humility and rights of childbearing women. The curriculum is specifically designed for all members of the care team and for adaptation and implementation in any level of clinical setting.
Results: The PRONTO strategy to promote kind and respectful care in different contexts will be described. We will show examples of activities and highly realistic obstetric simulation training videos that, with skilled debriefing, are used as a non-threatening way to identify and practice skills and strategies (verbal and nonverbal communication, position, birth companion, etc.) for providing appropriate care. Simulations also allow us to identify critical practice or system change opportunities to improve care for women during childbirth.
Conclusion: The techniques and activities employed by PRONTO to lead provider teams through self-reflection, practice, and finally a commitment to take concrete action to provide culturally humble, kind and respectful, maternity care to women in their facilities will be discussed. These are used as the foundation for appreciating patient-centered care.