Principles and processes behind promoting awareness of rights for quality maternal care services: a synthesis of stakeholder experiences and implementation factors
Loading...
Date
2017
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
BACKGROUND: Promoting awareness of rights is a value-based process that entails a different way of thinking and
acting, which is at times misunderstood or deemed as aspirational.
METHODS: Guided by the SURE framework, we undertook a secondary analysis of 26 documents identified by an earlier
systematic review on promoting awareness of rights to increase use of maternity care services. We thematically analysed
stakeholder experiences and implementation factors across the diverse initiatives to derive common elements to guide
future efforts.
RESULTS: Interventions that promote awareness of rights for maternal health varied in nature, methodological orientation,
depth and quality. Materials included booklets, posters, pamphlets/ briefs and service standards/charters. Target populations
included women, family members, communities, community structures, community-based and non governmental
organizations, health providers and administrators, as well as elected representatives. While one initiative only focused on
raising awareness, most were embedded within larger efforts to improve the accountability and responsiveness of service
delivery through community monitoring and advocacy, with a few aiming to change policies and contest elections.
Underlying these action oriented forms of promoting awareness of rights, was a critical consciousness and attitudinal
change gained through iterative capacity-building for all stakeholders; materials and processes that supported group
discussion and interaction; the formation or strengthening of community groups; situational analysis to ensure adaptation
to local context; facilitation to ensure common ground and language across stakeholders; and strategic networking and
alliance building across health system levels. While many positive experiences are discussed, few challenges or barriers to
implementation are documented. The limited documentation and poor quality of information found indicate that while
various examples of promoting awareness of rights for maternal health exists, research partnerships to systematically
evaluate their processes, learning and effects are lacking.
CONCLUSION: Rather than being aspirational, several examples of promoting awareness of women’s rights for quality
maternity care services exist. More than mainly disseminate information, they aim to change stakeholder mindsets and
relationships across health system levels. Due to their transformatory intent they require sustained investment, with
strategic planning, concrete operationalization and political adeptness to manage dynamic stakeholder expectations and
reactions overtime. More investment is also required in research partnerships that support such initiatives and better
elucidate their context specific variations.
Description
Keywords
Rights, Health promotion, Maternal health, Implementation, Context, Stakeholder perspectives
Citation
George, A.S. & Branchini, C. Principles and processes behind promoting awareness of rights for quality maternal care services: a synthesis of stakeholder experiences and implementation factors. BMC Pregnancy and Childbirth, 17: 264