Want to be partners for life, then fill the gaps!

“You are paid using our taxes from the garden and you also want me to buy a book” said a mother to a midwife who had asked her to buy a book were her medical information will be written since the health center had run out of stationery. This is one incident of disrespect to midwives that I have seen at a health facility in Lira among others, and this happens because of the gaps in the health system which affects the partnership between mothers and midwives. This mother’s response to the midwife left me dumbfounded but am certain it left the midwife very angry and I could have affected her attitude to all the other mothers seeking care.

The World Health Organisation states that every woman has the right to the highest attainable standard of health, including the right to dignified, respectful care during pregnancy and child birth but how do we attain this if the there is no relationship. Women who go to facilities for care may encounter disrespect in different ways but these problems are systemic and persist may be because; some providers lack awareness about patients rights, some are stressed and overworked because they are under staffed. This doesn’t necessarily mean it is okay for the disrespect to continue because of the above reasons, but how about we start with getting solutions like solutions like; increasing health worker force, updated and improved training , and with a good work environment. Mid wives will surely then provide respective, sensitive and effective maternity services to mothers.

As the world commemorates the International Day of the Midwife today, with the theme, ‘Midwives, Mothers and Families: Partners for Life!’, am thinking beyond partnership. I believe in partnership and this is by far one of the best partnerships, but with the continuous shortage of midwives in Uganda and other countries, who will mothers have this partnership with? How much time and attention is a midwife able to give to mothers if she is able to work? Midwives in most developing countries are overwhelmed but continue to serve because they want to see every mother happy as they bring new life to the world.

Midwives everywhere understand that working in partnership with women and their families, they can support them to make better decisions about what they need to have a safe and fulfilling birth. Shortage of midwives is not just the only problem and it is important to note that there is need to not only recruit and retain midwives but also fulfilling the needs of the health system. If needs like water, electricity, delivery kits, well equipped labor suites are not there, this greatly affects their attitude and might later affect the relationship or partnership we thought a midwife should be having with a mother.

I was excited when I got to know this year’s theme was on partnership because for last year’s International day of the midwife, I wrote about Pregnant woman – qualified midwife: The best partnership to reduce maternal deaths.

To all midwives thank you, ‘apwoyo atek’, ‘mwebale nyo’, yalama noi …….!!!!

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Disrespectful maternity care, a detterent to use of skilled health care

Did you know that today is the world Human Rights Day and also the last day of the sixteen days of activism against sexual and gender based violence. This year’s Human rights day is devoted to the launch of a year-long campaign for the 50th anniversary of the two International Covenants on Human Rights: the International Covenant on Economic, Social and Cultural Rights and the International Covenant on Civil and Political Rights, which were adopted by the United Nations General Assembly on 16 December 1966.

I want to dedicate this special day to all women and girls who were disrespected when they were under maternity care . Respectful maternity care (RMC) is a universal human right that is due to every childbearing woman in every health system. Human rights matter everyday for everyone everywhere so RMC is not for those who can afford out of pocket expenditures only but for every woman. Disrespect and abuse in childbirth may be from interactions or facility conditions that local consensus deems to be humiliating or undignified, and those interactions or conditions that are experienced as or intended to be humiliating or undignified. For example; physical abuse, verbal abuse, non-consented care, non-confidential care, non-dignified care, discrimination based on specific patient attributes, detention in facilities among others.

Women’s experiences with maternity caregivers can empower and comfort them, or inflict lasting damage and emotional trauma. The fear of disrespect and abuse that women often encounter in facility-based maternity care is a deterrent to use of skilled care yet the right to health requires health services that are available, accessible, acceptable and of good quality. But despite numerous official interpretations and guidance documents applying this right to childbirth, reports of disrespectful and abusive treatment during labour and delivery continue to appear.

Where could the problem be? Some health workers lack basic awareness about patients’ rights; some are stressed and overworked but we also have societies that have tolerate abusive behavior; and then health care systems may lack accountability and oversight mechanisms.
The World Health Organization (WHO) has taken a stand on preventing and eliminating disrespect and abuse, stating “Every woman has the right to the highest attainable standard of health, including the right to dignified, respectful care during pregnancy and childbirth.” We also have to ensure continued dialogue on providing and advocating for respectful maternal health care at both the local and global levels.

Women have the right to the enjoyment of the highest attainable standard of physical and mental health.The enjoyment of this right is vital to their life and their ability to participate in all areas of public and private life which further help in making the world a better place.