Efforts needed to improve person-centered maternity care

About 300,000 women died from problems related to pregnancy and childbirth in 2015. Almost all of them lived in low-income and middle-income countries. Care from skilled providers is key in preventing these deaths, but only half of births in these countries happen in healthcare facilities. One important factor driving people away from births in facilities is the lack of person-centered maternity care. Care that is respectful and responsive to women and their families’ preferences and values can help encourage women to seek care and improve maternal and infant health outcomes.

New research from Patience Afulani and colleagues is the first known study to measure person-centered maternity care in more than one country with the same tool. Researchers surveyed women in Kenya, Ghana and India using a scale to measure their experience of care. The results showed that serious efforts are needed to improve person-centered maternity care.

Across 4 settings in 3 countries, providers missed several core components of person-centered maternity care. They rarely introduced themselves, asked permission to do exams or procedures, explained procedures and medications or created an environment where women felt comfortable asking questions about their care. Women also had little involvement in decisions about their care, including the possibility of having birth companions present and the ability to choose their preferred delivery positions. There were relatively low reports of physical and verbal abuse compared to previous studies. However, person-centered maternity care is about much more than the absence of abuse.

It’s clear that there is much work needed to improve the quality of maternity care that women receive in health facilities in the developing world. Efforts to improve care can include provider training on the importance of person-centered care and strategies to deal with stress and biases. Measuring the impact of these changes will be crucial to holding providers and facilities accountable and improving women’s and infants’ health.