|
Maternal Health
As with family planning, quality is also important in
maternal health programmes,(61) and can increase the
likelihood that women facing obstetric emergencies
will go to health facilities for life-saving care. A study
of 164 households in Mexico where a maternal death
occurred found that perceived quality of health care
was a significant factor in a woman in labour delaying
seeking medical care.(62)
Other studies found similar concerns among
potential users. In Bolivia, women say they consider
respectful treatment to be crucial and that condescending
provider attitudes are the greatest deterrent to the
use of maternal health services.(63) A study in Yemen of
randomly selected households found that both rural and urban women preferred to deliver at home, despite
acknowledging the importance of their medical needs,
because they feared bad experiences or had prior bad
experiences with institutional deliveries.(64)
Since the ICPD, attention to quality services has
increased significantly, and many countries have
launched initiatives to improve maternal health care.
For example, with donor assistance, Azerbaijan initiated
a Safe Motherhood and Newborn Care project,
which includes capacity-building of health staff,
raising the awareness of women and adolescent girls
regarding healthy lifestyles, promoting a mother- and
baby-friendly environment at maternity units, and
giving special attention to vulnerable populations.
Several governments in the Caribbean have established
maternal and child health committees or
technical advisory groups, whose members include
doctors, nurses and social workers.(65)
Training providers is an important element in
providing improved care and overcoming clients’
reservations about seeking out available services.
It can also have positive impacts on maternal health
outcomes.(66) For example, a training programme in
Moldova led to sites welcoming fathers or family
members as support persons for women in labour,
maternity hospitals allowing family visits post-partum,
women reporting a decline in invasive practices, and
more parents attending new childbirth classes.(67)
And after 24 trainers were trained in the Ukraine,
induction of labour and Caesarean sections were less
frequent, and providers reported that they felt that the
women giving birth were happier.(68) Training providers in Russia resulted in a huge increase in clients spending
the night in a hospital following delivery, from
0.5 per cent to 86 per cent one year later.(69)
|
21 |
MEETING CLIENTS’ NEEDS IN PERU |
|
At a MaxSalud primary health clinic in a peri-urban community in Peru, health managers were concerned by low
utilization rates in 2000 among their mostly female clientele. An assessment found that women were reluctant to get reproductive health services from the male gynaecologist after the midwife
transferred to another clinic. Prices were reduced, an aggressive publicity campaign was launched to advertise the new fees, and a certified midwife was reinstated as part of the clinic’s quality
improvement intervention. Service utilization rates rose dramatically.
Female clients reported high satisfaction with women’s health services and a preference for female providers. See Sources
|
|
|
|
